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.
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
Citation
Clinical Chemistry, 2016, 63 (1), pp.325-333
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
Medical Laboratory Technology
LONG-TERM RISK
CARDIOVASCULAR EVENTS
PROGNOSTIC VALUE
BIOMARKERS
COMMUNITY
CARDIOMYOCYTES
ASSOCIATION
DYSFUNCTION
DARAPLADIB
STRESS
Publication Status
Published