Growth Differentiation Factor 15 Predicts AM-Cause Morbidity and Mortality in Stable Coronary Heart Disease
Author(s)
Type
Journal Article
Abstract
Background-—Growth differentiation factor-15 (GDF-15) is related to major bleeding when measured at initial presentation in patients with acute coronary syndromes (ACSs) treated with dual antiplatelet therapy. It is unknown whether follow-up measurements provide additional information. The objective of this study was to investigate whether GDF-15 measured 1 month after an ACS provides additional information beyond the baseline levels with regard to the risk of major bleeding. Methods and Results-—GDF-15 was measured at baseline and at 1 month after an ACS in 4049 patients included in the PLATelet inhibition and patient Outcomes (PLATO) trial. The association between 1-month GDF-15 level and non–coronary artery bypass grafting surgery-related major bleeding was assessed by a multivariable Cox model, adjusting for baseline GDF-15, age, anemia, impaired renal function, history of gastrointestinal bleeding, and sex. Elevated GDF-15 (>1800 ng/L) at 1 month was associated with an increased risk of non-coronary artery bypass grafting-related major bleeding (3.9% versus 1.2%; hazard ratio, 3.38; 95% CI, 1.89–6.06), independent of baseline GDF-15. Patients who had elevated GDF-15 levels at baseline and subsequent nonelevated GDF-15 at 1 month had a similar risk as patients who had nonelevated levels at both measurements. Conclusions-—GDF-15 at 1 month after an ACS is related to the risk of bleeding during DAPT and provides additional information on the bleeding risk beyond baseline GDF-15 levels. GDF-15 levels may therefore be useful as part of decision support concerning long-term antithrombotic treatment in patients post-ACS.
Date Issued
2016-12-30
Date Acceptance
2016-09-13
ISSN
1530-8561
Publisher
American Association for Clinical Chemistry
Start Page
325
End Page
333
Journal / Book Title
Clinical Chemistry
Volume
63
Issue
1
Copyright Statement
© 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the Creative Commons
Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is noncommercial
and no modifications or adaptations are made.
Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is noncommercial
and no modifications or adaptations are made.
Subjects
Science & Technology
Life Sciences & Biomedicine
Cardiac & Cardiovascular Systems
Cardiovascular System & Cardiology
biomarker
bleeding
ischemic heart disease
DUAL ANTIPLATELET THERAPY
FACTOR-15/MACROPHAGE INHIBITORY CYTOKINE-1
OUTCOMES PLATO TRIAL
CARDIOVASCULAR EVENTS
MYOCARDIAL-INFARCTION
PLATELET INHIBITION
CLOPIDOGREL
TICAGRELOR
DISEASE
BIOMARKERS
Medical Laboratory Technology
LONG-TERM RISK
PROGNOSTIC VALUE
COMMUNITY
CARDIOMYOCYTES
ASSOCIATION
DYSFUNCTION
DARAPLADIB
STRESS
Adult
Aged
Biomarkers
Coronary Disease
Female
Growth Differentiation Factor 15
Humans
Male
Middle Aged
Morbidity
Prospective Studies
Risk Factors
Survival Rate
STABILITY Investigators
Publication Status
Published