1. Prognostic value of growth differentiation factor-15 in Chinese patients with heart failure: A prospective observational study
- Author
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Qingyong Chen, Xianchao Jing, Yingying Li, Jiefu Yang, and Hua Wang
- Subjects
Male ,medicine.medical_specialty ,China ,Growth Differentiation Factor 15 ,Time Factors ,030204 cardiovascular system & hematology ,Risk Assessment ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Internal medicine ,Cause of Death ,medicine ,Humans ,030212 general & internal medicine ,Prospective Studies ,Prospective cohort study ,Survival rate ,Survival analysis ,Cause of death ,Aged ,Aged, 80 and over ,Heart Failure ,Proportional hazards model ,business.industry ,Hazard ratio ,Stroke Volume ,General Medicine ,Middle Aged ,Prognosis ,Confidence interval ,Survival Rate ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business ,Mace ,Biomarkers ,Follow-Up Studies - Abstract
Background: Growth differentiation factor-15 (GDF-15), a biomarker associated with remodeling, oxidative stress and inflammation, has been used to stratify heart failure (HF) patients. However, its prognostic value in Chinese HF patients is still unknown. Methods: GDF-15 levels were examined on admission in 272 consecutive HF patients in Beijing Hospital (a Chinese tertiary medical center) by a commercial enzyme-linked immunosorbent assay. We recorded the incidence of all-cause mortality and/or readmission for HF during a median follow-up period of 558 days. Patients were stratified according to the tertiles of GDF-15. Results: Fifty-three (19.5%) patients died and 103 (37.9%) patients had major adverse cardiac events (MACE) which included the composite outcome of all-cause mortality or readmission for HF at the end of follow-up. Kaplan-Meier survival curves showed that the third tertile of GDF-15 was associated with increased rate of all-cause mortality (compared with the first and second tertiles, log rank p = 0.001 and 0.001, respectively) or MACE (compared with the first and second tertiles, log rank p = 0.002 and p < 0.001, respectively). In addition, multivariate Cox regression model showed that the highest tertile of GDF-15 was independently associated with increased risk of all-cause death (hazard ratio = 5.95, 95% confidence interval 1.88โ18.78, p = 0.002) compared with the lowest tertile after adjustment for related clinical variables such as age, renal function or N-terminal pro-B-type natriuretic peptide. Conclusions: Plasma GDF-15 is an independent predictor of all-cause mortality in Chinese patients with HF. It may potentially be used to stratify and prognosticate HF patients.
- Published
- 2016