Growth differentiation factor 15 is associated with cardiovascular outcomes in patients with coronary artery disease

Abstract

Background: Growth differentiation factor-15 (GDF-15) is a marker of inflammation, oxidative stress and it is associated with adverse prognosis in cardiovascular disease. The aim of the present cohort study is to investigate the prognostic value of GDF-15 in patients with coronary artery disease (CAD) during long-term follow up.Method: A total of 3641 consecutive patients with CAD were prospectively enrolled into the study and followed up for all cause death and major adverse cardiovascular events (MACEs) up to 6.4 years. Plasma GDF-15 was measured and clinical data and long-term events were registered. The patients were subsequently divided into three groups by the levels of GDF-15 and the association of GDF-15 level with MACEs was evaluated.Result: After a median follow-up at 6.4 years later, 775 patients (event rate of 21%) had developed MACEs and 275 patients died (event rate of 7.55%). Kaplan–Meier analysis indicated that the patients with GDF-15 > 1800 ng/L were significantly associated with an increased risk of MACEs and all cause death. After adjustment for potential confounders, GDF-15 > 1800 ng/L. were independently associated with the composite of major adverse cardiovascular events (MACEs) (HR 1.74; 95% CI: 1.44–2.02; p<0.001) and all-cause death (HR 2.04; 95% CI 1.57– 2.61; p<0.001). For MACEs a significant increase of receiver operator characteristic curve (ROC)curve was seen after addition of GDF-15 to a clinical model 0.628(95% CI 0.605–0.651; p <0.001).For long-term all-cause death a significant increase of ROC curve was seen after addition of GDF-15 to a clinical model 0.817(95% CI 0.787–0.846; p<0.001).Conclusions: In the setting of CAD, GDF-15 is associated with long-term all-cause death, MACEs and provides incremental prognostic value beyond traditional risks factors.

Exploring the Link Between the Serum/Blood Levels of Heavy Metals (Pb, As, Cd, and Cu) and 2 Novel Biomarkers of Cardiovascular Stress (Growth Differentiation Factor 15 and Soluble Suppression of Tumorigenicity 2) in Copper Smelter Workers

“…Very recent studies illustrated a positive association between increased GDF-15 levels and atherosclerotic CVD, heart failure, markers of subclinical myocardial stress or injury, and diabetes. These results demonstrated the potential utility of GDF-15 as a robust biomarker of adverse cardiometabolic outcomes and CVD risk stratification according to its level 70–72 . Furthermore, an increased level of sST2 was found to be a significant and independent predictor of cardiovascular events in multiple recent studies.…”

“…These results demonstrated the potential utility of GDF-15 as a robust biomarker of adverse cardiometabolic outcomes and CVD risk stratification according to its level. [70][71][72] Furthermore, an increased level of sST2 was found to be a significant and independent predictor of cardiovascular events in multiple recent studies. In addition, elevated sST2 concentrations were linked to an increased risk for major adverse cardiovascular events and all-cause mortality in individuals with coronary artery disease.…”

Prognostic value of ST2 for MACEs and all-cause mortality in patients with coronary artery disease during a long-term follow up

“…The design, details, and primary results of the study have been reported previously [19]. To be brief, the purpose of the study is to evaluate different biomarkers' prognostic value of adverse cardiac events in patients with CAD.…”

NXNL1 negatively regulates osteoblast differentiation via GDF15‐induced PP2A Cα dependent manner in MC3T3‐E1 cells

“…Growth differentiation factor 15 (GDF15) is a member of the transforming growth factor β family that mediates inflammatory responses and stress signals 9,10 . In addition, GDF15 expression level is increased in cancer, cardiovascular disease, and multiple myeloma 11–13 . GDF15 plays a variety of roles in metabolism, including glucose metabolism, fat metabolism, and bone metabolism.…”

“…9,10 In addition, GDF15 expression level is increased in cancer, cardiovascular disease, and multiple myeloma. [11][12][13] GDF15 plays a variety of roles in metabolism, including glucose metabolism, fat metabolism, and bone metabolism. It has been used as a biomarker to diagnose the presence or absence of diabetes in patients with metabolic syndrome.…”