Document Detail


Growth-differentiation factor-15 for risk stratification in patients with stable and unstable coronary heart disease: results from the AtheroGene study.
MedLine Citation:
PMID:  20031597     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Growth-differentiation factor-15 (GDF-15) is a stress-responsive transforming growth factor-beta-related cytokine that has emerged as a prognostic biomarker in acute coronary syndrome trial populations. Its predictive role in stable coronary heart disease (CHD) has never been assessed. METHODS AND RESULTS: The circulating levels of GDF-15 were measured by immunoradiometric assay in patients with stable angina pectoris (n=1352) or acute coronary syndrome (n=877) who were followed up for a median of 3.6 years. Stable angina pectoris patients presenting with normal (<1200 ng/L), moderately elevated (1200 to 1800 ng/L), or markedly elevated (>1800 ng/L) GDF-15 levels had 3.6-year CHD mortality rates of 1.4%, 2.7%, and 15.0%, respectively (P<0.001). By backward stepwise Cox-regression analysis, which adjusted for age and gender, clinical variables, the number of diseased vessels, renal function, the levels of C-reactive protein, cardiac troponin I, and N-terminal pro-B-type natriuretic peptide, GDF-15 remained an independent predictor of CHD mortality (P<0.001). Addition of GDF-15 improved the prognostic accuracy of a clinical risk prediction model concerning CHD mortality (c-statistic, 0.84 versus 0.74; P=0.005). Analysis of the acute coronary syndrome part of the study population confirmed GDF-15 as an independent predictor of CHD mortality (P<0.001). The circulating levels of GDF-15 did not predict the future risk of nonfatal myocardial infarction in patients with stable angina pectoris or acute coronary syndrome. CONCLUSIONS: This study identifies GDF-15 as a strong and independent predictor of CHD mortality across the broad spectrum of patients with stable and unstable CHD.
Authors:
Tibor Kempf; Jan-Malte Sinning; Anja Quint; Christoph Bickel; Christoph Sinning; Philipp S Wild; Renate Schnabel; Edith Lubos; Hans J Rupprecht; Thomas M?nzel; Helmut Drexler; Stefan Blankenberg; Kai C Wollert
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-03-31
Journal Detail:
Title:  Circulation. Cardiovascular genetics     Volume:  2     ISSN:  1942-3268     ISO Abbreviation:  Circ Cardiovasc Genet     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-12-24     Completed Date:  2010-03-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101489144     Medline TA:  Circ Cardiovasc Genet     Country:  United States    
Other Details:
Languages:  eng     Pagination:  286-92     Citation Subset:  IM    
Affiliation:
Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany.
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MeSH Terms
Descriptor/Qualifier:
Acute Coronary Syndrome / diagnosis*,  mortality,  radiography
Aged
Angina Pectoris / diagnosis*,  mortality,  radiography
Female
Growth Differentiation Factor 15 / blood*
Humans
Male
Middle Aged
Prognosis
Regression Analysis
Risk Factors
Survival Analysis
Chemical
Reg. No./Substance:
0/Growth Differentiation Factor 15
Comments/Corrections
Comment In:
Circ Cardiovasc Genet. 2009 Jun;2(3):209-11   [PMID:  20031588 ]

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