Abstract 14892: Sex Difference in the Prognostic Power of Growth Differentiation Factor 15 for Cardiovascular Event: The Japan Morning Surge-Home Blood Pressure Study

Abstract

Introduction: Growth differentiation factor 15 (GDF-15), a cytokine secreted in response to cellular stress and inflammation, has been associated with cardiovascular event. Although previous studies have reported that there was a close association between sex hormones and GDF-15, data are sparse about sex difference in the prognostic power of GDF-15 for cardiovascular event. Hypothesis: We hypothesized that there is the differential prognostic power of GDF-15 for cardiovascular outcome according to gender. Methods: This prospective practitioner-based cohort study was conducted between 2005 and 2012 and included participants in the Japan Morning Surge-Home Blood Pressure Study with a history of at least one cardiovascular event who had GDF-15 measurements at baseline. Results: The study included 4066 participants (mean age 64.8 years; men, n=1897; women, n=2169). During an average 6.2 years follow-up, 249 cardiovascular events (coronary artery disease, stroke and heart failure) occurred. GDF-15 levels were significantly higher in the male vs. the female group (median [interquartile], 1014 [741.3-1432] ng/L vs. 909.9 [671.6-1257] ng/L; P<0.001). In women, multivariate Cox analysis revealed that after adjusting other potential predictors, log-transformed GDF-15 was independently associated with cardiovascular events (Hazard ratio [HR], 2.09; 95% confidence interval [CI], 1.31-3.35; P=0.002), whereas this association was not found in men. In women, higher GDF-15 (≥1200 ng/L) was independently associated with cardiovascular event (HR, 2.23; 95%CI, 1.41-3.53; P=0.001), whereas this association was not found in men. The interaction between higher GDF-15 and cardiovascular event according to sex tended to be significant (P=0.087). Conclusions: There is a sex difference in the prognostic power of GDF-15 for cardiovascular event.