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Prognostic value of...
Prognostic value of growth-differentiation factor-15 in patients with non-ST-elevation acute coronary syndrome
- Article/chapterEnglish2007
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LIBRIS-ID:oai:DiVA.org:uu-17358
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https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-17358URI
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https://doi.org/10.1161/CIRCULATIONAHA.106.650846DOI
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Language:English
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Summary in:English
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
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BACKGROUND: Growth-differentiation factor-15 (GDF-15) is a member of the transforming growth factor-beta cytokine superfamily that is induced in the heart after ischemia-and-reperfusion injury. Circulating levels of GDF-15 may provide prognostic information in patients with non-ST-elevation acute coronary syndrome. METHODS AND RESULTS: Blood samples were obtained on admission from 2081 patients with acute chest pain and either ST-segment depression or troponin elevation who were included in the Global Utilization of Strategies to Open Occluded Arteries (GUSTO)-IV Non-ST-Elevation Acute Coronary Syndrome trial and from a matching cohort of 429 apparently healthy individuals. GDF-15 levels were determined by immunoradiometric assay. Approximately two thirds of patients presented with GDF-15 levels above the upper limit of normal in healthy controls (1200 ng/L); one third presented with levels >1800 ng/L. Increasing tertiles of GDF-15 were associated with an enhanced risk of death at 1 year (1.5%, 5.0%, and 14.1%; P<0.001). By multiple Cox regression analysis, only the levels of GDF-15 and N-terminal pro-B-type natriuretic peptide, together with age and a history of previous myocardial infarction, contributed independently to 1-year mortality risk. Receiver operating characteristic curve analyses further illustrated that GDF-15 is a strong marker of 1-year mortality risk (area under the curve, 0.757; best cutoff, 1808 ng/L). At this cutoff value, GDF-15 added significant prognostic information in patient subgroups defined by age; gender; time from symptom onset to admission; cardiovascular risk factors; previous cardiovascular disease; and the risk markers ST-segment depression, troponin T, N-terminal pro-B-type natriuretic peptide, C-reactive protein, and creatinine clearance. CONCLUSIONS: GDF-15 is a new biomarker of the risk for death in patients with non-ST-elevation acute coronary syndrome that provides prognostic information beyond that provided by established clinical and biochemical markers.
Subject headings and genre
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Acute coronary syndrome
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Biomarkers
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Growth-differentiation factor-15
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Prognosis
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MEDICINE
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MEDICIN
Added entries (persons, corporate bodies, meetings, titles ...)
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Kempf, Tibor
(author)
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Peter, Timo
(author)
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Olofsson, Sylvia,1955-Uppsala universitet,Uppsala kliniska forskningscentrum (UCR)(Swepub:uu)syolo424
(author)
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James, Stefan,1964-Uppsala universitet,Uppsala kliniska forskningscentrum (UCR)(Swepub:uu)stjam367
(author)
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Johnston, NinaUppsala universitet,Uppsala kliniska forskningscentrum (UCR)(Swepub:uu)ninjo389
(author)
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Lindahl, Bertil,1957-Uppsala universitet,Uppsala kliniska forskningscentrum (UCR)(Swepub:uu)belin227
(author)
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Horn-Wichmann, Rüdiger
(author)
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Brabant, Georg
(author)
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Simoons, Maarten L.
(author)
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Armstrong, Paul W.
(author)
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Califf, Robert M.
(author)
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Drexler, Helmut
(author)
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Wallentin, Lars,1943-Uppsala universitet,Uppsala kliniska forskningscentrum (UCR)(Swepub:uu)larswall
(author)
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Uppsala universitetUppsala kliniska forskningscentrum (UCR)
(creator_code:org_t)
Related titles
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In:Circulation115:8, s. 962-9710009-73221524-4539
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Wollert, Kai C.
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Kempf, Tibor
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Peter, Timo
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Olofsson, Sylvia ...
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James, Stefan, 1 ...
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Johnston, Nina
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Lindahl, Bertil, ...
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Brabant, Georg
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Simoons, Maarten ...
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Drexler, Helmut
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Circulation
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Uppsala University