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Growth-differentiation factor-15 for early risk stratification in patients with acute chest pain
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
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2008 (English)In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 29, no 19, 2327-2335 p.Article in journal (Refereed) Published
Abstract [en]

AIMS: Growth-differentiation factor-15 (GDF-15) has emerged as a biomarker of increased mortality and recurrent myocardial infarction (MI) in patients diagnosed with non-ST-elevation acute coronary syndrome. We explored the usefulness of GDF-15 for early risk stratification in 479 unselected patients with acute chest pain. METHODS AND RESULTS: Sixty-nine per cent of the patients presented with GDF-15 levels above the previously defined upper reference limit (1200 ng/L). The risks of the composite endpoint of death or (recurrent) MI after 6 months were 1.3, 5.1, and 12.6% in patients with normal (<1200 ng/L), moderately elevated (1200-1800 ng/L), or markedly elevated (>1800 ng/L) levels of GDF-15 on admission, respectively (P < 0.001). By multivariable analysis that included clinical characteristics, ECG findings, peak cardiac troponin I levels within 2 h (cTnI(0-2 h)), N-terminal pro-B-type natriuretic peptide, C-reactive protein, and cystatin C, GDF-15 remained an independent predictor of the composite endpoint. The ability of the ECG combined with peak cTnI(0-2 h) to predict the composite endpoint was markedly improved by addition of GDF-15 (c-statistic, 0.74 vs. 0.83; P < 0.001). CONCLUSION: GDF-15 improves risk stratification in unselected patients with acute chest pain and provides prognostic information beyond clinical characteristics, the ECG, and cTnI.

Place, publisher, year, edition, pages
2008. Vol. 29, no 19, 2327-2335 p.
Keyword [en]
Growth-differentiation factor-15, Acute chest pain, Risk stratification, Biomarker
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Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-104701DOI: 10.1093/eurheartj/ehn339ISI: 000259768700005PubMedID: 18664460OAI: oai:DiVA.org:uu-104701DiVA: diva2:220066
Available from: 2009-05-29 Created: 2009-05-29 Last updated: 2017-12-13Bibliographically approved

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Eggers, Kai M.Lindahl, BertilWallentin, Lars

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