Growth Differentiation Factor-15 in Patients Recovering From Acute Coronary Syndromes

Abstract

Plasma concentrations of growth differentiation factor-15 (GDF-15) are known to be prognostic in patients with acute coronary syndromes (ACS). However, the pattern of GDF-15 in the months post-ACS remains uncertain. This study aimed to investigate the temporal pattern of circulating GDF-15 in the intermediate to long-term post-ACS. The Biomarker-guided Risk Management following Acute Coronary Syndrome (BioMACS) clinical trial enrolled patients between 1 month and 12 months post-discharge after an ACS. Patients were selected from the trial Usual Care arm, with equal numbers of non-ST elevation myocardial infarction (NSTEMI) and STEMI. Groups were matched by time from ACS. GDF-15 was measured at baseline and 3 months using the ROCHE Cobas assay. Sixty patients were included, 30% were female, and the median age was 67 years. Ethnicity was 81% European, 2% Māori, 7% Pacific, 7% Asian, and 3% Indian. For the whole group, mean GDF-15 concentrations were 1,430 (standard deviation [SD] 632) pg/mL at baseline, and 1,348 (SD 626) pg/mL at 3 months. No significant differences in GDF-15 concentrations were found between NSTEMI and STEMI groups at both timepoints. The change from baseline to 3 months was –93 (SD 462) pg/mL, with no statistically significant difference in the change between the NSTEMI and STEMI groups. GDF-15 was related to age, systolic blood pressure, and measures of renal function (creatinine and estimated glomerular filtration rate). GDF-15 concentrations were elevated in the months post-ACS but remained stable over a further 3-month period. The prognostic role of this biomarker in the convalescent period post-ACS needs to be assessed in future research studies.