Temporal Pattern of Growth Differentiation Factor-15 Protein After Acute Coronary Syndrome (From the BIOMArCS Study)

Abstract

for the BIOMArCS investigators Growth differentiation factor-15 (GDF-15) has appeared as a promising biomarker with strong predictive abilities in acute coronary syndrome (ACS). However, studies are solely based on single measurements in the acute phase of an ACS event. The way GDF-15 patterns in post-ACS patients behave on the long term is largely unknown. We conducted a nested case-control study within our multicenter, prospective, observational biomarker study (BIOMArCS) of 844 ACS patients. Following an index ACS event, high-frequency blood sampling was performed during 1-year of follow-up. GDF-15 was determined batchwise by electrochemiluminescence immunoassays in 37 cases with a recurrent event during 1-year follow-up, and in 74 event-free controls. Cases and controls had a mean § standard deviation age of 66.9 § 11.3 years and 81% were men. From 30 days onwards, patients showed stable levels, which were on average 333 (95% confidence interval 68 to 647) pg/mL higher in cases than controls (1704 vs 1371 pg/mL; p value 0.013). Additionally, in the post 30-day period, GDF-15 showed low within-individual variability in both cases and controls. In conclusion, post-ACS patients experiencing a recurrent event had stable and systematically higher GDF-15 levels during 30-day to 1-year follow-up than their event-free counterparts with otherwise similar clinical characteristics. Thus, postdischarge blood sampling might be used throughout the course of 1 year to improve prognostication, whereas, in view of the low within-individual variation, the number of repeated sampling moments might be limited.

Growth differentiation factor 15 and cardiovascular risk: individual patient meta-analysis

“…Unlike troponin or BNP, acute myocardial injury induces only a modest increase of GDF-15 in the circulation (approximately 5% median increase), which occurs in the first week after an uncomplicated ACS event, and gradually returns back to baseline within 30 days. 32 , 33 This observation is supported by studies that suggest only a weak association between GDF-15 and extent of myocardial damage. 3 , 19 , 33 Similarly, HF studies have also reported low intraindividual and a higher interindividual biological variation with GDF-15.…”

“… 32 , 33 This observation is supported by studies that suggest only a weak association between GDF-15 and extent of myocardial damage. 3 , 19 , 33 Similarly, HF studies have also reported low intraindividual and a higher interindividual biological variation with GDF-15. 34 , 35 …”

Evaluation of Arterial Stiffness Parameters and the Growth Differentiation Factor-15 Level in Patients with Premature Myocardial Infarction

“…Similar to the patients with stable CAD, GDF-15 levels are elevated in patients with ACS. In addition, there is also a significant association between high GDF-15 levels and mortality and recurrent MI in patients with ACS [28,29]. While a study suggested the use of GDF-15 in the early risk stratification of patients with acute chest pain [9], another study with a longer follow-up period reported that post-ACS patients who experience a recurrent event have stable and systematically higher GDF-15 levels during 30-days to 1-year follow-up compared to the event-free post-ACS patients [28].…”

Research Status of Growth Differentation Factor-15 in Acute Coronary Syndrome

“…GDF-15 has been found to be associated with recurrent events following ACS [28]. Further studies conducted by Nermina Buljubasic et al [29] demonstrated that the concentration of GDF-15 in patients with recurrent myocardial infarction after ACS was 26% higher than that in patients with non-recurrent ACS. Additionally, the concentration of GDF-15 in patients with recurrent events remained significantly higher than that in patients with non-recurrent ACS within 1 year.…”