Sabirzyanova A A, Galyavich A S, Baleeva L V, Galeeva Z M
Kazan State Medical University, Kazan, Russia.
Kardiologiia. 2020 Dec 15;60(11):1251. doi: 10.18087/cardio.2020.11.n1251.
Aim To reveal relationships between growth differentiation factor-15 (GDF-15) and laboratory and instrumental indexes in patients with myocardial infarction in acute phase.Material and methods The study included 118 patients younger than 70 years with ST-segment elevation or non-ST segment elevation myocardial infarction (MI). For these patients, GDF-15 was measured by enzyme immunoassay within 48 h of MI clinical onset along with a routine examination. Statistical significance of differences in qualitative variables was assessed by the Student's t-test for normal distribution and by the nonparametric Mann-Whitney U-test; significance of differences in quantitative variables was assessed by the Pearson's chi-squared test. The presence of a relationship between quantitative variables was assessed with the Pearson's correlation coefficient and the Spearman's rank correlation coefficient.Results For patients with MI, mean GDF-15 concentration was 2.25±1.0 ng/ml. Moderate correlations were found for GDF-15 and levels of natriuretic peptide (r=0.36, p<0.01), white blood cells (r=0.32, p<0.01), and ejection fraction (Simpson rule) (r=-0.32, p<0.01); weak correlations were found with levels of troponin I (r=0.21, p=0.02) and urea (r=0.20, p=0.04), and interventricular septal thickness by echocardiography (r= -0.26, p<0.01). GDF-15 was higher in patients with ST-segment elevation MI (2.36±1.02 vs 1.99±0.96, p<0.05) and in the presence of hypo- or akinetic areas (2.35±1.05 vs 1.85±0.70, p<0.05). No dependence of GDF-15 on the presence of traditional cardiovascular risk factors was observed.Conclusion GDF-15 correlates with major markers of myocardial injury; its level is higher in patients with ST-segment elevation MI regardless of the infarct location.
目的 揭示急性期心肌梗死患者生长分化因子-15（GDF-15）与实验室及仪器检查指标之间的关系。
材料与方法 本研究纳入118例年龄小于70岁的ST段抬高型或非ST段抬高型心肌梗死（MI）患者。对这些患者在MI临床发病后48小时内采用酶免疫分析法测定GDF-15，并进行常规检查。定性变量差异的统计学显著性通过正态分布的Student t检验和非参数Mann-Whitney U检验进行评估；定量变量差异的显著性通过Pearson卡方检验进行评估。定量变量之间关系的存在通过Pearson相关系数和Spearman等级相关系数进行评估。
结果 对于MI患者，GDF-15平均浓度为2.25±1.0 ng/ml。发现GDF-15与利钠肽水平（r = 0.36，p<0.01）、白细胞（r = 0.32，p<0.01）以及射血分数（Simpson法则）（r = -0.32，p<0.01）呈中度相关；与肌钙蛋白I水平（r = 0.21，p = 0.02）和尿素（r = 0.20，p = 0.04）以及超声心动图测得的室间隔厚度（r = -0.26，p<0.01）呈弱相关。ST段抬高型MI患者的GDF-15水平更高（2.36±1.02 vs 1.99±0.96，p<0.05），存在运动减弱或无运动区域的患者GDF-15水平也更高（2.35±1.05 vs 1.85±0.70，p<0.05）。未观察到GDF-15与传统心血管危险因素之间的相关性。
结论 GDF-15与心肌损伤的主要标志物相关；无论梗死部位如何，ST段抬高型MI患者的GDF-15水平更高。
