Growth Differentiation Factor 15, Its 12-Month Relative Change, and Risk of Cardiovascular Events and Total Mortality in Patients with Stable Coronary Heart Disease: 10-Year Follow-up of the KAROLA Study.

Dallmeier, Dhayana; Brenner, Hermann; Mons, Ute; Rottbauer, Wolfgang; Koenig, Wolfgang; Rothenbacher, Dietrich

doi:10.1373/clinchem.2016.254755

journal article

Document type:: Journal Article; Article
Author(s):: Dallmeier, Dhayana; Brenner, Hermann; Mons, Ute; Rottbauer, Wolfgang; Koenig, Wolfgang; Rothenbacher, Dietrich
Title:: Growth Differentiation Factor 15, Its 12-Month Relative Change, and Risk of Cardiovascular Events and Total Mortality in Patients with Stable Coronary Heart Disease: 10-Year Follow-up of the KAROLA Study.
Abstract:: This study considered whether baseline concentrations and 12-month changes of growth differentiation factor 15 (GDF-15) are associated with subsequent cardiovascular events (CVEs) and total mortality in patients with stable coronary heart disease.Baseline GDF-15 serum concentrations were measured in 1073 participants in a cardiac rehabilitation program (median follow-up 10 years). GDF-15 associations with subsequent CVE and total mortality were evaluated by Cox-proportional hazards models adjusting for well-established cardiovascular risk factors (Model 2), plus N-terminal probrain natriuretic peptide, high-sensitivity (hs) CRP, and hs cardiac troponin T (Model 3).In our study population [84.7% men, mean age 59 years, median baseline GDF-15 1232 ng/L (interquartile range, 916, 1674)] we observed 190 CVE and 162 deaths. Compared to participants with GDF-15 <1200 ng/L, increased risk for death was found in participants with GDF-15 >=1200 and <=1800 ng/L [hazard ratio (HR) 1.68 (95% CI, 1.08-2.62)] and with GDF-15 >1800 ng/L [HR 1.73 (1.02-2.94)], even in Model 3. The 12-month relative median change was -16.7%. As compared to participants with 12-month relative changes between -20% and 20%, GDF-15 increments >20% were associated with: a) an HR of 1.84 (1.04-3.26) for CVE in Model 2, but found nonsignificant in Model 3; (b) an HR of 2.26 (1.32-3.86) for death even in Model 3.GDF-15 at baseline is independently associated with subsequent CVE and 10-year total mortality. Twelve-month relative changes remained associated with subsequent CVE when adjusting for well-established cardiovascular risk factors, and with total mortality even after further adjustment for established cardiac biomarkers.
Journal title abbreviation:: Clin Chem
Year:: 2016
Journal volume:: 62
Journal issue:: 7
Pages contribution:: 982-92
Language:: eng
Fulltext / DOI:: doi:10.1373/clinchem.2016.254755
Pubmed ID:: http://view.ncbi.nlm.nih.gov/pubmed/27197673
Print-ISSN:: 0009-9147
TUM Institution:: Klinik für Herz- und Kreislauferkrankungen im Erwachsenenalter (Prof. Schunkert)
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mediaTUM Gesamtbestand Einrichtungen Schools TUM School of Medicine and Health Departments Clinical Medicine Lehr- und Forschungskooperationen mit den Kliniken und Instituten am Deutschen Herzzentrum Klinik für Herz- und Kreislauferkrankungen im Erwachsenenalter (DHM) (Prof. Schunkert)2016