AIMS: Growth-differentiation factor-15 (GDF-15) is a transforming growth factor-beta-related cytokine that is induced in the heart following ischaemia-reperfusion injury. We explored the prognostic utility of GDF-15 in patients with ST-segment elevation myocardial infarction (STEMI) receiving fibrinolytic therapy. METHODS AND RESULTS: Circulating levels of GDF-15 were determined by an immunoradiometric assay in 741 STEMI patients who were included in the Assessment of the Safety and Efficacy of a New Thrombolytic (ASSENT)-2 and ASSENT-plus trials. About 72.7% of the patients presented with GDF-15 levels > or =1200 ng/L, the upper limit of normal in apparently healthy elderly individuals. Increased levels of GDF-15 were associated with a higher risk of death during 1-year follow-up. Mortality rates at 1 year were 2.1, 5.0, and 14.0% in patients with GDF-15 levels <1200, 1200-1800, and >1800 ng/L, respectively (P < 0.001). GDF-15 remained an independent predictor of mortality after adjustment for clinical variables, troponin T, and N-terminal pro-B-type natriuretic peptide (NT-proBNP). GDF-15 provided prognostic information in clinically relevant patient subgroups, defined according to age, gender, cardiovascular risk factors, haemodynamic status, and the TIMI risk score. Moreover, GDF-15 added prognostic information to the established biomarkers of adverse prognosis in STEMI, troponin T, and NT-proBNP. CONCLUSION: GDF-15 is a new biomarker in STEMI that provides prognostic information beyond established clinical and biochemical markers.
AIMS: Growth-differentiation factor-15 (GDF-15) is a transforming growth factor-beta-related cytokine that is induced in the heart following ischaemia-reperfusion injury. We explored the prognostic utility of GDF-15 in patients with ST-segment elevation myocardial infarction (STEMI) receiving fibrinolytic therapy. METHODS AND RESULTS: Circulating levels of GDF-15 were determined by an immunoradiometric assay in 741 STEMI patients who were included in the Assessment of the Safety and Efficacy of a New Thrombolytic (ASSENT)-2 and ASSENT-plus trials. About 72.7% of the patients presented with GDF-15 levels > or =1200 ng/L, the upper limit of normal in apparently healthy elderly individuals. Increased levels of GDF-15 were associated with a higher risk of death during 1-year follow-up. Mortality rates at 1 year were 2.1, 5.0, and 14.0% in patients with GDF-15 levels <1200, 1200-1800, and >1800 ng/L, respectively (P < 0.001). GDF-15 remained an independent predictor of mortality after adjustment for clinical variables, troponin T, and N-terminal pro-B-type natriuretic peptide (NT-proBNP). GDF-15 provided prognostic information in clinically relevant patient subgroups, defined according to age, gender, cardiovascular risk factors, haemodynamic status, and the TIMI risk score. Moreover, GDF-15 added prognostic information to the established biomarkers of adverse prognosis in STEMI, troponin T, and NT-proBNP. CONCLUSION:GDF-15 is a new biomarker in STEMI that provides prognostic information beyond established clinical and biochemical markers.
Authors: Anand Rohatgi; Parag Patel; Sandeep R Das; Colby R Ayers; Amit Khera; Abelardo Martinez-Rumayor; Jarett D Berry; Darren K McGuire; James A de Lemos Journal: Clin Chem Date: 2011-11-07 Impact factor: 8.327
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Authors: Shannon E Mullican; Xiefan Lin-Schmidt; Chen-Ni Chin; Jose A Chavez; Jennifer L Furman; Anthony A Armstrong; Stephen C Beck; Victoria J South; Thai Q Dinh; Tanesha D Cash-Mason; Cassandre R Cavanaugh; Serena Nelson; Chichi Huang; Michael J Hunter; Shamina M Rangwala Journal: Nat Med Date: 2017-08-28 Impact factor: 53.440
Authors: Thomas J Wang; Kai C Wollert; Martin G Larson; Erin Coglianese; Elizabeth L McCabe; Susan Cheng; Jennifer E Ho; Michael G Fradley; Anahita Ghorbani; Vanessa Xanthakis; Tibor Kempf; Emelia J Benjamin; Daniel Levy; Ramachandran S Vasan; James L Januzzi Journal: Circulation Date: 2012-08-20 Impact factor: 29.690