TY  - JOUR
A1  - Tzikas, Stergios
A1  - Palapies, Lars
A1  - Bakogiannis, Constantinos
A1  - Zeller, Tanja
A1  - Sinning, Christoph
A1  - Baldus, Stephan
A1  - Bickel, Christoph
A1  - Vassilikos, Vassilios
A1  - Lackner, Karl Johannes
A1  - Zeiher, Andreas M.
A1  - Münzel, Thomas
A1  - Blankenberg, Stefan
A1  - Keller, Till
T1  - GDF-15 predicts cardiovascular events in acute chest pain patients
T2  - PLoS one
N2  - 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.
Y1  - 2017
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/43976
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-439769
SN  - 1932-6203
N1  - Copyright: © 2017 Tzikas et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
VL  - 12
IS  - (8): e0182314
SP  - 1
EP  - 13
PB  - PLoS
CY  - Lawrence, Kan.
ER  -