Universität zu Köln

Tzikas, Stergios ORCID: 0000-0002-7811-5620, Palapies, Lars, Bakogiannis, Constantinos, Zeller, Tanja, Sinning, Christoph, Baldus, Stephan, Bickel, Christoph, Vassilikos, Vassilios, Lackner, Karl J., Zeiher, Andreas, Muenzel, Thomas, Blankenberg, Stefan and Keller, Till (2017). GDF-15 predicts cardiovascular events in acute chest pain patients. PLoS One, 12 (8). SAN FRANCISCO: PUBLIC LIBRARY SCIENCE. ISSN 1932-6203

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Abstract

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.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Tzikas, Stergios UNSPECIFIED orcid.org/0000-0002-7811-5620 UNSPECIFIED Palapies, Lars UNSPECIFIED UNSPECIFIED UNSPECIFIED Bakogiannis, Constantinos UNSPECIFIED UNSPECIFIED UNSPECIFIED Zeller, Tanja UNSPECIFIED UNSPECIFIED UNSPECIFIED Sinning, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Baldus, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED Bickel, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Vassilikos, Vassilios UNSPECIFIED UNSPECIFIED UNSPECIFIED Lackner, Karl J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Zeiher, Andreas UNSPECIFIED UNSPECIFIED UNSPECIFIED Muenzel, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Blankenberg, Stefan UNSPECIFIED UNSPECIFIED UNSPECIFIED Keller, Till UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-221980
DOI:	10.1371/journal.pone.0182314
Journal or Publication Title:	PLoS One
Volume:	12
Number:	8
Date:	2017
Publisher:	PUBLIC LIBRARY SCIENCE
Place of Publication:	SAN FRANCISCO
ISSN:	1932-6203
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language GROWTH-DIFFERENTIATION FACTOR-15; RISK STRATIFICATION; EARLY-DIAGNOSIS; HEART-DISEASE; BIOMARKERS; MEMBER; REVASCULARIZATION; ASSOCIATION; POPULATION; MORTALITY Multiple languages Multidisciplinary Sciences Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/22198