Wang Wei, Song Xian-Tao, Chen Yun-Dai, Yuan Fei, Xu Feng, Zhang Min, Tan Kai, Yang Xing-Sheng, Yu Xian-Peng, Cui Kong-Yong, Lyu Shu-Zheng
Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University and Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China.
Department of Cardiology, the First Medical Center of Chinese PLA General Hospital, Beijing, China.
J Geriatr Cardiol. 2020 Apr;17(4):210-216. doi: 10.11909/j.issn.1671-5411.2020.04.004.
Growth differentiation factor-15 (GDF-15) is involved in multiple processes that are associated with coronary artery disease (CAD). However, little is known about the association between GDF-15 and the future ischemic events in patients with intermediate CAD. This study was conducted to investigate whether plasma GDF-15 constituted risk biomarkers for future cardiovascular events in patients with intermediate CAD.
A prospective study was performed based on 541 patients with intermediate CAD (20%-70%). GDF-15 of each patient was determined in a blinded manner. The primary endpoint was major adverse cardiac event (MACE), which was defined as a composite of all-cause death, nonfatal myocardial infarction, revascularization and readmission due to angina pectoris.
After a median follow-up of 64 months, 504 patients (93.2%) completed the follow-up. Overall, the combined endpoint of MACE appeared in 134 patients (26.6%) in the overall population: 26 patients died, 11 patients suffered a nonfatal myocardial infarction, 51 patients underwent revascularization, and 46 patients were readmitted for angina pectoris. The plasma levels of GDF-15 (median: 1172.02 965.25 pg/mL, = 0.014) were higher in patients with ischemic events than those without events. After adjusting for traditional risk factors, higher GDF-15 levels were significantly associated with higher incidence of the composite endpoint of MACE (HR = 1.244, 95% CI: 1.048-1.478, Quartile 4 Quartile 1, = 0.013).
The higher level of GDF-15 was an independent predictor of long-term adverse cardiovascular events in patients with intermediate CAD.
生长分化因子15（GDF-15）参与了与冠状动脉疾病（CAD）相关的多个过程。然而，关于GDF-15与中度CAD患者未来缺血事件之间的关联知之甚少。本研究旨在调查血浆GDF-15是否构成中度CAD患者未来心血管事件的风险生物标志物。
对541例中度CAD（20%-70%）患者进行了一项前瞻性研究。以盲法测定每位患者的GDF-15。主要终点是主要不良心脏事件（MACE），定义为全因死亡、非致命性心肌梗死、血运重建和因心绞痛再次入院的综合结果。
中位随访64个月后，504例患者（93.2%）完成了随访。总体而言，MACE的联合终点在总体人群中的134例患者（26.6%）中出现：26例患者死亡，11例患者发生非致命性心肌梗死，51例患者接受了血运重建，46例患者因心绞痛再次入院。发生缺血事件的患者血浆GDF-15水平（中位数：1172.02±965.25 pg/mL，P = 0.014）高于未发生事件的患者。在调整传统危险因素后，较高的GDF-15水平与MACE综合终点的较高发生率显著相关（HR = 1.244，95%CI：1.048-1.478，四分位数4与四分位数1比较，P = 0.013）。
较高水平的GDF-15是中度CAD患者长期不良心血管事件的独立预测因子。
