Abstract
BackgroundGrowth differentiation factor-15 (GDF-15) is a marker of inflammation, oxidative stress and it is associated with adverse prognosis in cardiovascular disease. The aim of the present cohort study is to investigate the prognostic value of GDF-15 in patients with coronary artery disease (CAD) during long-term follow up.MethodsA total of 3641 consecutive patients with CAD were prospectively enrolled into the study and followed up for major adverse cardiovascular events (MACEs) and all-cause death up to 5.3–7.6 years. Plasma GDF-15 was measured and clinical data and long-term events were registered. The patients were subsequently divided into three groups by the levels of GDF-15 and the prognostic value of GDF-15 level with MACEs and all-cause death was evaluated.ResultsAfter a median follow-up at 6.4 years later, 775 patients (event rate of 21%) had developed MACEs and 275 patients died (event rate of 7.55%). Kaplan–Meier analysis indicated that the patients with GDF-15 > 1800 ng/L were significantly associated with an increased risk of MACEs and all-cause death. Cox regression analysis indicated that GDF-15 > 1800 ng/L were independently associated with the composite of MACEs (HR 1.74; 95% CI 1.44–2.02; P < 0.001) and all-cause death (HR 2.04; 95% CI 1.57–2.61; P < 0.001). For MACEs, GDF-15 significantly improved the C-statistic (area under the curve, 0.583 [95% CI 0.559–0.606] to 0.628 [0.605–0.651]; P < 0.001), net reclassification index (0.578; P = 0.031), and integrated discrimination index (0.021; P = 0.027). For all-cause death, GDF-15 significantly improved the C-statistic (0.728 [95% CI 0.694–0.761] to 0.817 [0.781–0.846]; P < 0.001), net reclassification index (0.629; P = 0.001), and integrated discrimination index (0.035; P = 0.002).ConclusionsIn the setting of CAD, GDF-15 is associated with long-term MACEs and all-cause death, and provides incremental prognostic value beyond traditional risks factors.
Highlights
Growth differentiation factor-15 (GDF-15) is a marker of inflammation, oxidative stress and it is associ‐ ated with adverse prognosis in cardiovascular disease
Patient characteristics A total of 3641 patients diagnosed as coronary artery disease (CAD) admitted to our hospital were enrolled in the present study
Univariate Cox proportional analyses revealed that Growth and differentiation factor 15 (GDF15) values > 1800 ng/L were significantly associated with the incidence of major adverse cardiovascular events (MACEs)
Summary
Growth differentiation factor-15 (GDF-15) is a marker of inflammation, oxidative stress and it is associ‐ ated with adverse prognosis in cardiovascular disease. Li et al Cardiovasc Diabetol (2020) 19:120 include gender, age, smoking, glucose level, blood pressure and cholesterol level have long been used to risk stratify subjects who are at risk of MACEs [2, 3]. These clinical risk factors themselves have limited predictive value in patients with CAD. In the past decade, accumulating evidence has demonstrated that the GDF-15 serve as a potential prognostic factor in patients in with acute coronary syndrome [12,13,14] These studies did not elucidate the long-term prognostic value of MACEs in CAD patients. The aim of the present study was to investigate the long-term prognostic value of plasma GDF-15 on all-cause death and MACEs in a large scale patients during a long-term follow up with established CAD
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
