Growth Differentiation Factor-15 and Risk of Recurrent Events in Patients Stabilized After Acute Coronary Syndrome
Key result
Higher GDF-15 concentrations at hospital discharge after ACS were independently associated with an increased 2-year risk of death or MI (adjusted HR per ln increase 2.1; 95% CI 1.6-2.9; P<0.001).
Why the study?
Does GDF-15 concentration at hospital discharge predict the risk of recurrent events in patients stabilized after acute coronary syndrome?
Population
3,501 patients stabilized after acute coronary syndrome, treated with moderate or intensive statin therapy…
Comparison
GDF-15 concentration measured at hospital… vs Lower vs higher GDF-15 concentrations
Design
Cohort
Follow-up
2 years
Authors
Discussion
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Member takes
Implication
Supports GDF-15 for post-ACS prognostication; leaves open whether it refines risk models or guides therapy.
Key Points
- The study aims to assess the risk of death, myocardial infarction, and congestive heart failure using GDF-15 levels in patients stabilized after acute coronary syndrome.
- Measured GDF-15 levels in 3501 patients post-ACS treated with statin therapy in PROVE IT-TIMI 22.
- Used established cutoff points for GDF-15 concentrations to analyze risk associations.
- Conducted adjustments for various clinical predictors including age, sex, and diabetes.
- GDF-15 levels associated with a 2-year risk of death or MI at different concentration cutoffs: 5.7% (<1200 ng/L), 8.1% (1200-1800 ng/L), 15.1% (>1800 ng/L; P<0.001).
- Adjusted hazard ratio for death or MI per ln increase in GDF-15 is 2.1 (95% CI, 1.6 to 2.9; P<0.001).
- No significant interaction between GDF-15 levels and intensive statin therapy regarding death or MI risk (P=0.24).
Study Design
Type
Cohort (n=3,501)
Structured PICO
Does GDF-15 concentration at hospital discharge predict the risk of recurrent events in patients stabilized after acute coronary syndrome?
P
Population
3,501 patients stabilized after acute coronary syndrome (ACS), treated with moderate or intensive statin therapy in the PROVE IT-TIMI 22 trial.
I
Intervention
GDF-15 concentration measured at hospital discharge
C
Comparator
Lower vs higher GDF-15 concentrations (<1200, 1200-1800, and >1800 ng/L)
O
Outcome
2-year risk of death or myocardial infarction (MI)composite
Main Result
Effect estimate: adjusted HR 2.1 (95% CI 1.6 to 2.9)
p-value: p=<0.001
GDF-15 measured at hospital discharge is a strong, independent prognostic marker for recurrent events (death, MI, heart failure) in patients stabilized after ACS.
Cite This Study
Bonaca et al. (2010) conducted a cohort in Acute Coronary Syndrome (n=3,501). GDF-15 vs. <1200, 1200-1800, and >1800 ng/L was evaluated on death or MI (adjusted HR 2.1, 95% CI 1.6 to 2.9, p=<0.001). Higher GDF-15 concentrations at hospital discharge after ACS were independently associated with an increased 2-year risk of death or MI (adjusted HR per ln increase 2.1; 95% CI 1.6-2.9; P<0.001).