Change in Growth Differentiation Factor 15, but Not C-Reactive Protein, Independently Predicts Major Cardiac Events in Patients with Non-ST Elevation Acute Coronary Syndrome

Abstract

Among the numerous emerging biomarkers, high-sensitivity C-reactive protein (hsCRP) and growth-differentiation factor-15 (GDF-15) have received widespread interest, with their potential role as predictors of cardiovascular risk. The concentrations of inflammatory biomarkers, however, are influenced, among others, by physiological variations, which are the natural, within-individual variation occurring over time. The aims of our study are: (a) to describe the changes in hsCRP and GDF-15 levels over a period of time and after an episode of non-ST-segment elevation acute coronary syndrome (NSTE-ACS) and (b) to examine whether the rate of change in hsCRP and GDF-15 after the acute event is associated with long-term major cardiovascular adverse events (MACE). Two hundred and Fifty five NSTE-ACS patients were included in the study. We measured hsCRP and GDF-15 concentrations, at admission and again 36 months after admission (end of the follow-up period). The present study shows that the change of hsCRP levels, measured after 36 months, does not predict MACE in NSTEACS-patients. However, the level of GDF-15 measured, after 36 months, was a stronger predictor of MACE, in comparison to the acute unstable phase.

Growth differentiation factor 15 in adverse cardiac remodelling: from biomarker to causal player

“…[15][16][17][18] GDF15 is easily detectable in the blood; however, concentrations vary with age and gender. 15,[19][20][21] For instance, we have shown that circulating levels of GDF15 can serve as strong independent predictor for cardiovascular events in women but not in men. 22 Although GDF15 has a sex-dependent prognostic value in heart failure patients, 23 the prognostic value of GDF15 is not standardly analysed for men and women separately to increase accuracy.…”

“…Elevated protein expression of circulating growth differentiation factor 15 (GDF15) is correlated to many pathological conditions, mainly being different types of cancer and also metabolic diseases such as obesity and diabetes 15–18 . GDF15 is easily detectable in the blood; however, concentrations vary with age and gender 15,19–21 . For instance, we have shown that circulating levels of GDF15 can serve as strong independent predictor for cardiovascular events in women but not in men 22 .…”

Relationship between hepcidin and GDF15 in anemic patients with type 2 diabetes without overt renal impairment

“…GDF15 is a member of the transforming growth factor-beta (TGF-b) superfamily [25]. The expression of GDF15 is elevated in many types of malignancies, cardiovascular diseases, inflammatory diseases and type 2 diabetes [26][27][28][29]. Although the exact role and mechanism are as-yet-unknown, the putative role of GDF15 is as an anti-inflammatory cytokine.…”

The Correlation of Serum Growth Differentiation Factor-15 Level in Patients with Obstructive Sleep Apnea

“…It is pointed that GDF-15 level is associated with the risk of death and myocardial infarction independent of clinical variables and other biomarkers [ 16 ]. Dominguez-Rodriguez et al [ 17 ] measured the level of GDF-15 and high-sensitivity C-reactive protein (hsCRP) in patients with acute coronary syndrome at admission and again 36 months after admission. They found that the change of hsCRP levels, measured after 36 months, does not estimate major cardiovascular adverse events (MACE) in patients with acute coronary syndrome.…”