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GDF-15 predicts cardiovascular events in acute chest pain patients
BACKGROUND: Treatment of patients presenting with possible acute myocardial infarction (AMI) is based on timely diagnosis and proper risk stratification aided by biomarkers. We aimed at evaluating the predictive value of GDF-15 in patients presenting with symptoms suggestive of AMI. METHODS: Consecu...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5542604/ https://www.ncbi.nlm.nih.gov/pubmed/28771550 http://dx.doi.org/10.1371/journal.pone.0182314 |
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author | Tzikas, Stergios Palapies, Lars Bakogiannis, Constantinos Zeller, Tanja Sinning, Christoph Baldus, Stephan Bickel, Christoph Vassilikos, Vassilios Lackner, Karl J. Zeiher, Andreas Münzel, Thomas Blankenberg, Stefan Keller, Till |
author_facet | Tzikas, Stergios Palapies, Lars Bakogiannis, Constantinos Zeller, Tanja Sinning, Christoph Baldus, Stephan Bickel, Christoph Vassilikos, Vassilios Lackner, Karl J. Zeiher, Andreas Münzel, Thomas Blankenberg, Stefan Keller, Till |
author_sort | Tzikas, Stergios |
collection | PubMed |
description | BACKGROUND: Treatment of patients presenting with possible acute myocardial infarction (AMI) is based on timely diagnosis and proper risk stratification aided by biomarkers. We aimed at evaluating the predictive value of GDF-15 in patients presenting with symptoms suggestive of AMI. METHODS: Consecutive patients presenting with suspected AMI were enrolled in three study centers. Cardiovascular events were assessed during a follow-up period of 6 months with a combined endpoint of death or MI. RESULTS: From the 1818 enrolled patients (m/f = 1208/610), 413 (22.7%) had an acute MI and 63 patients reached the combined endpoint. Patients with MI and patients with adverse outcome had higher GDF-15 levels compared with non-MI patients (967.1pg/mL vs. 692.2 pg/L, p<0.001) and with event-free patients (1660 pg/mL vs. 756.6 pg/L, p<0.001). GDF-15 levels were lower in patients with SYNTAX score ≤ 22 (797.3 pg/mL vs. 947.2 pg/L, p = 0.036). Increased GDF-15 levels on admission were associated with a hazard ratio of 2.1 for death or MI (95%CI: 1.67–2.65, p<0.001) in a model adjusted for age and sex and of 1.57 (1.13–2.19, p = 0.008) adjusted for the GRACE score variables. GDF-15 showed a relevant reclassification with regards to the GRACE score with an overall net reclassification index (NRI) of 12.5% and an integrated discrimination improvement (IDI) of 14.56% (p = 0.006). CONCLUSION: GDF-15 is an independent predictor of future cardiovascular events in patients presenting with suspected MI. GDF-15 levels correlate with the severity of CAD and can identify and risk-stratify patients who need coronary revascularization. |
format | Online Article Text |
id | pubmed-5542604 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-55426042017-08-12 GDF-15 predicts cardiovascular events in acute chest pain patients Tzikas, Stergios Palapies, Lars Bakogiannis, Constantinos Zeller, Tanja Sinning, Christoph Baldus, Stephan Bickel, Christoph Vassilikos, Vassilios Lackner, Karl J. Zeiher, Andreas Münzel, Thomas Blankenberg, Stefan Keller, Till PLoS One Research Article BACKGROUND: Treatment of patients presenting with possible acute myocardial infarction (AMI) is based on timely diagnosis and proper risk stratification aided by biomarkers. We aimed at evaluating the predictive value of GDF-15 in patients presenting with symptoms suggestive of AMI. METHODS: Consecutive patients presenting with suspected AMI were enrolled in three study centers. Cardiovascular events were assessed during a follow-up period of 6 months with a combined endpoint of death or MI. RESULTS: From the 1818 enrolled patients (m/f = 1208/610), 413 (22.7%) had an acute MI and 63 patients reached the combined endpoint. Patients with MI and patients with adverse outcome had higher GDF-15 levels compared with non-MI patients (967.1pg/mL vs. 692.2 pg/L, p<0.001) and with event-free patients (1660 pg/mL vs. 756.6 pg/L, p<0.001). GDF-15 levels were lower in patients with SYNTAX score ≤ 22 (797.3 pg/mL vs. 947.2 pg/L, p = 0.036). Increased GDF-15 levels on admission were associated with a hazard ratio of 2.1 for death or MI (95%CI: 1.67–2.65, p<0.001) in a model adjusted for age and sex and of 1.57 (1.13–2.19, p = 0.008) adjusted for the GRACE score variables. GDF-15 showed a relevant reclassification with regards to the GRACE score with an overall net reclassification index (NRI) of 12.5% and an integrated discrimination improvement (IDI) of 14.56% (p = 0.006). CONCLUSION: GDF-15 is an independent predictor of future cardiovascular events in patients presenting with suspected MI. GDF-15 levels correlate with the severity of CAD and can identify and risk-stratify patients who need coronary revascularization. Public Library of Science 2017-08-03 /pmc/articles/PMC5542604/ /pubmed/28771550 http://dx.doi.org/10.1371/journal.pone.0182314 Text en © 2017 Tzikas et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Tzikas, Stergios Palapies, Lars Bakogiannis, Constantinos Zeller, Tanja Sinning, Christoph Baldus, Stephan Bickel, Christoph Vassilikos, Vassilios Lackner, Karl J. Zeiher, Andreas Münzel, Thomas Blankenberg, Stefan Keller, Till GDF-15 predicts cardiovascular events in acute chest pain patients |
title | GDF-15 predicts cardiovascular events in acute chest pain patients |
title_full | GDF-15 predicts cardiovascular events in acute chest pain patients |
title_fullStr | GDF-15 predicts cardiovascular events in acute chest pain patients |
title_full_unstemmed | GDF-15 predicts cardiovascular events in acute chest pain patients |
title_short | GDF-15 predicts cardiovascular events in acute chest pain patients |
title_sort | gdf-15 predicts cardiovascular events in acute chest pain patients |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5542604/ https://www.ncbi.nlm.nih.gov/pubmed/28771550 http://dx.doi.org/10.1371/journal.pone.0182314 |
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