GDF-15 predicts cardiovascular events in acute chest pain patients
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GDF-15 predicts cardiovascular events in acute chest pain patients. / Tzikas, Stergios; Palapies, Lars; Bakogiannis, Constantinos; Zeller, Tanja; Sinning, Christoph; Baldus, Stephan; Bickel, Christoph; Vassilikos, Vassilios; Lackner, Karl J; Zeiher, Andreas; Münzel, Thomas; Blankenberg, Stefan; Keller, Till.
in: PLOS ONE, Jahrgang 12, Nr. 8, e0182314, 2017.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - GDF-15 predicts cardiovascular events in acute chest pain patients
AU - Tzikas, Stergios
AU - Palapies, Lars
AU - Bakogiannis, Constantinos
AU - Zeller, Tanja
AU - Sinning, Christoph
AU - Baldus, Stephan
AU - Bickel, Christoph
AU - Vassilikos, Vassilios
AU - Lackner, Karl J
AU - Zeiher, Andreas
AU - Münzel, Thomas
AU - Blankenberg, Stefan
AU - Keller, Till
PY - 2017
Y1 - 2017
N2 - BACKGROUND: Treatment of patients presenting with possible acute myocardial infarction (AMI) is based on timely diagnosis and proper risk stratification aided by biomarkers. We aimed at evaluating the predictive value of GDF-15 in patients presenting with symptoms suggestive of AMI.METHODS: Consecutive patients presenting with suspected AMI were enrolled in three study centers. Cardiovascular events were assessed during a follow-up period of 6 months with a combined endpoint of death or MI.RESULTS: From the 1818 enrolled patients (m/f = 1208/610), 413 (22.7%) had an acute MI and 63 patients reached the combined endpoint. Patients with MI and patients with adverse outcome had higher GDF-15 levels compared with non-MI patients (967.1pg/mL vs. 692.2 pg/L, p<0.001) and with event-free patients (1660 pg/mL vs. 756.6 pg/L, p<0.001). GDF-15 levels were lower in patients with SYNTAX score ≤ 22 (797.3 pg/mL vs. 947.2 pg/L, p = 0.036). Increased GDF-15 levels on admission were associated with a hazard ratio of 2.1 for death or MI (95%CI: 1.67-2.65, p<0.001) in a model adjusted for age and sex and of 1.57 (1.13-2.19, p = 0.008) adjusted for the GRACE score variables. GDF-15 showed a relevant reclassification with regards to the GRACE score with an overall net reclassification index (NRI) of 12.5% and an integrated discrimination improvement (IDI) of 14.56% (p = 0.006).CONCLUSION: GDF-15 is an independent predictor of future cardiovascular events in patients presenting with suspected MI. GDF-15 levels correlate with the severity of CAD and can identify and risk-stratify patients who need coronary revascularization.
AB - BACKGROUND: Treatment of patients presenting with possible acute myocardial infarction (AMI) is based on timely diagnosis and proper risk stratification aided by biomarkers. We aimed at evaluating the predictive value of GDF-15 in patients presenting with symptoms suggestive of AMI.METHODS: Consecutive patients presenting with suspected AMI were enrolled in three study centers. Cardiovascular events were assessed during a follow-up period of 6 months with a combined endpoint of death or MI.RESULTS: From the 1818 enrolled patients (m/f = 1208/610), 413 (22.7%) had an acute MI and 63 patients reached the combined endpoint. Patients with MI and patients with adverse outcome had higher GDF-15 levels compared with non-MI patients (967.1pg/mL vs. 692.2 pg/L, p<0.001) and with event-free patients (1660 pg/mL vs. 756.6 pg/L, p<0.001). GDF-15 levels were lower in patients with SYNTAX score ≤ 22 (797.3 pg/mL vs. 947.2 pg/L, p = 0.036). Increased GDF-15 levels on admission were associated with a hazard ratio of 2.1 for death or MI (95%CI: 1.67-2.65, p<0.001) in a model adjusted for age and sex and of 1.57 (1.13-2.19, p = 0.008) adjusted for the GRACE score variables. GDF-15 showed a relevant reclassification with regards to the GRACE score with an overall net reclassification index (NRI) of 12.5% and an integrated discrimination improvement (IDI) of 14.56% (p = 0.006).CONCLUSION: GDF-15 is an independent predictor of future cardiovascular events in patients presenting with suspected MI. GDF-15 levels correlate with the severity of CAD and can identify and risk-stratify patients who need coronary revascularization.
KW - Acute Disease
KW - Aged
KW - Biomarkers/analysis
KW - Chest Pain/etiology
KW - Female
KW - Growth Differentiation Factor 15/analysis
KW - Humans
KW - Kaplan-Meier Estimate
KW - Lipoproteins, HDL/blood
KW - Lipoproteins, LDL/blood
KW - Male
KW - Middle Aged
KW - Myocardial Infarction/diagnosis
KW - Proportional Hazards Models
KW - Risk Factors
KW - Severity of Illness Index
KW - Troponin I/blood
U2 - 10.1371/journal.pone.0182314
DO - 10.1371/journal.pone.0182314
M3 - SCORING: Journal article
C2 - 28771550
VL - 12
JO - PLOS ONE
JF - PLOS ONE
SN - 1932-6203
IS - 8
M1 - e0182314
ER -