Association Between Growth Differentiation Factor-15 and Coagulation Parameters in Male Chinese Patients With Coronary Artery Disease

Background: Growth differentiation factor-15 (GDF-15) has emerged as a novel biomarker for coronary artery disease (CAD). Although the hypercoagulable state is recognized as a biological mechanism that triggers cardiac events in CAD, the relationship between GDF-15 and coagulation parameters in patients with CAD remains unclear. Thus, this study aimed to investigate the potential relationship between GDF-15 and coagulation parameters in male Chinese patients with CAD. Methods: In total, 892 subjects were enrolled between January 2020 and December 2020, including 592 with CAD and 300 controls. The serum levels of GDF-15, blood cell count, glucose, serum lipids, and coagulation parameters were measured. Kruskal–Wallis or one-way ANOVA with post hoc tests (Holm–Sidak and Dunn's tests), as well as univariate/multivariate linear regression analyses, were used to determine the correlation between GDF-15 and coagulation parameters in male patients with CAD. Results: Compared to controls, patients with acute myocardial infarction (AMI) and stable angina (SA) showed significantly higher levels of GDF-15 (p < 0.05). Multivariate linear regression revealed that GDF-15 levels were positively associated with activated partial thromboplastin time (APTT) in patients with CAD (β = 0.109, p = 0.024), and inversely associated with antithrombin III (AT3) (β = –0.113, p = 0.028) in an adjusted multivariate regression model. Meanwhile, in a multivariate regression model adjusted for other variables, the GDF-15 levels in patients with SA were inversely associated with AT3 (β = –0.191, p = 0.036). After adjusting for confounders, the GDF-15 levels were positively associated with APTT (β = 0.174, p = 0.002) and inversely associated with monocyte count (β = –0.159, p = 0.025) in patients with AMI. Conclusions: Elevated levels of GDF-15 in male CAD patients are associated with altered coagulation parameters, suggesting that GDF-15 may serve as a compensatory marker for coagulation parameter instability. These results underscore the potential clinical value of GDF-15 as a novel biomarker for assessing the coagulation status in patients with CAD, especially in the acute coronary syndrome (ACS) subgroup.