Determinants of growth differentiation factor 15 in patients with stable and acute coronary artery disease. A prospective observational study

Cardiovascular Diabetology

Original Investigation

Serdar Farhan¹  Matthias K. Freynhofer¹  Birgit Vogel¹  Ioannis Tentzeris¹  Ivan Brozovic¹  Kurt Huber¹  Sabina Baumgartner-Parzer²  Alexandra Kautzky-Willer²  Veronika Bruno³ 

[1] 3rd Department of Medicine, Cardiology, Wilhelminen Hospital, Montleartstrasse 37, A-1160, Vienna, Austria;3rd Department of Medicine, Division of Endocrinology and Metabolism, Medical University of Vienna, Vienna, Austria;Department of Obstetrics and Gynecology, Wilhelminen Hospital, Vienna, Austria;

关键词: Growth differentiation factor 15;    Acute coronary syndrome;    Coronary artery disease;    Diabetes mellitus;    Acute hyperglycemia;   

DOI  :  10.1186/s12933-016-0375-8

 received in 2016-01-24, accepted in 2016-03-24,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundGrowth differentiation factor 15 (GDF-15) is a member of the transforming growth factor ß family and has been associated with inflammation, cancer, aging, diabetes mellitus (DM) and atherosclerosis. Determinants of GDF-15 have been investigated in several conditions. We aimed to investigate determinants of GDF-15 plasma levels in patients with angiographically proven coronary artery disease (CAD).MethodsFour hundred and seventy three consecutive patients with CAD were investigated between May 2009 and February 2011. Patients were separated into those with stable CAD (SCAD) and with ST-elevation and non-ST-elevation myocardial infarction (STEMI and NSTEMI). Blood samples for determination of GDF-15 were obtained before coronary angiography. Determinant of GDF-15 levels were analyzed by logistic regression analysis in unadjusted and adjusted models. Study endpoints were cardiovascular death (CV-death), myocardial infarction, unstable angina, unplanned revascularization, stent thrombosis and stroke assessed at a mean follow-up of 188 (177.2–243) days.ResultsOverall median and (25–27th percentile) GDF-15 level was 1212.8 pg/ml (833.2–1957 pg/ml). GDF-15 was significantly higher in STEMI compared to SCAD and NSTEMI groups (P < 0.0001). In a multivariate regression analysis advanced age, DM, acute hyperglycemia (AHG), CRP and chronic kidney disease (CKD) were independent predictors of elevated GDF-15 levels (P < 0.05). Receiver operating curve analysis of GDF-15 for prediction of CV-death showed an area under the curve of 0.852 with a confidence interval of 0.745-0.960, P < 0.0001. The estimated cut-off was 2094.6 pg/ml with a sensitivity of 76 % and specificity of 80 %.ConclusionIn patients with CAD undergoing PCI with stent implantation, GDF-15 is determined by advanced age, acute and chronic hyperglycemia, inflammation and CKD. GDF-15 is a valuable predictor of CV-death in a population of CAD patients after PCI.

【 授权许可】

CC BY   
© Farhan et al. 2016