Growth-differentiation factor-15 for risk stratification in patients with stable and unstable coronary heart disease: results from the AtheroGene study
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Growth-differentiation factor-15 for risk stratification in patients with stable and unstable coronary heart disease: results from the AtheroGene study. / Kempf, Tibor; Sinning, Jan-Malte; Quint, Anja; Bickel, Christoph; Sinning, Christoph; Wild, Philipp S; Schnabel, Renate; Lubos, Edith; Rupprecht, Hans J; Münzel, Thomas; Drexler, Helmut; Blankenberg, Stefan; Wollert, Kai C.
in: CIRC-CARDIOVASC GENE, Jahrgang 2, Nr. 3, 06.2009, S. 286-292.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Growth-differentiation factor-15 for risk stratification in patients with stable and unstable coronary heart disease: results from the AtheroGene study
AU - Kempf, Tibor
AU - Sinning, Jan-Malte
AU - Quint, Anja
AU - Bickel, Christoph
AU - Sinning, Christoph
AU - Wild, Philipp S
AU - Schnabel, Renate
AU - Lubos, Edith
AU - Rupprecht, Hans J
AU - Münzel, Thomas
AU - Drexler, Helmut
AU - Blankenberg, Stefan
AU - Wollert, Kai C
PY - 2009/6
Y1 - 2009/6
N2 - 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.
AB - 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.
KW - Acute Coronary Syndrome/diagnosis
KW - Aged
KW - Angina Pectoris/diagnosis
KW - Female
KW - Growth Differentiation Factor 15/blood
KW - Humans
KW - Male
KW - Middle Aged
KW - Prognosis
KW - Radiography
KW - Regression Analysis
KW - Risk Factors
KW - Survival Analysis
U2 - 10.1161/CIRCGENETICS.108.824870
DO - 10.1161/CIRCGENETICS.108.824870
M3 - SCORING: Journal article
C2 - 20031597
VL - 2
SP - 286
EP - 292
JO - CIRC-CARDIOVASC GENE
JF - CIRC-CARDIOVASC GENE
SN - 1942-325X
IS - 3
ER -