Determinants of growth differentiation factor 15 in patients with stable and acute coronary artery disease. A prospective observational studyReportar como inadecuado




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Cardiovascular Diabetology

, 15:60

First Online: 08 April 2016Received: 24 January 2016Accepted: 24 March 2016

Abstract

BackgroundGrowth differentiation factor 15 GDF-15 is a member of the transforming growth factor ß family and has been associated with inflammation, cancer, aging, diabetes mellitus DM and atherosclerosis. Determinants of GDF-15 have been investigated in several conditions. We aimed to investigate determinants of GDF-15 plasma levels in patients with angiographically proven coronary artery disease CAD.

MethodsFour hundred and seventy three consecutive patients with CAD were investigated between May 2009 and February 2011. Patients were separated into those with stable CAD SCAD and with ST-elevation and non-ST-elevation myocardial infarction STEMI and NSTEMI. Blood samples for determination of GDF-15 were obtained before coronary angiography. Determinant of GDF-15 levels were analyzed by logistic regression analysis in unadjusted and adjusted models. Study endpoints were cardiovascular death CV-death, myocardial infarction, unstable angina, unplanned revascularization, stent thrombosis and stroke assessed at a mean follow-up of 188 177.2–243 days.

ResultsOverall median and 25–27th percentile GDF-15 level was 1212.8 pg-ml 833.2–1957 pg-ml. GDF-15 was significantly higher in STEMI compared to SCAD and NSTEMI groups P < 0.0001. In a multivariate regression analysis advanced age, DM, acute hyperglycemia AHG, CRP and chronic kidney disease CKD were independent predictors of elevated GDF-15 levels P < 0.05. Receiver operating curve analysis of GDF-15 for prediction of CV-death showed an area under the curve of 0.852 with a confidence interval of 0.745-0.960, P < 0.0001. The estimated cut-off was 2094.6 pg-ml with a sensitivity of 76 % and specificity of 80 %.

ConclusionIn patients with CAD undergoing PCI with stent implantation, GDF-15 is determined by advanced age, acute and chronic hyperglycemia, inflammation and CKD. GDF-15 is a valuable predictor of CV-death in a population of CAD patients after PCI.

KeywordsGrowth differentiation factor 15 Acute coronary syndrome Coronary artery disease Diabetes mellitus Acute hyperglycemia  Download fulltext PDF



Autor: Serdar Farhan - Matthias K. Freynhofer - Ivan Brozovic - Veronika Bruno - Birgit Vogel - Ioannis Tentzeris - Sabina Baumga

Fuente: https://link.springer.com/article/10.1186/s12933-016-0375-8



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