Addition of GDF-15 to ECG and peak cTnI improved the prediction of 6-month death or recurrent MI in patients with acute chest pain (c-statistic 0.83 vs 0.74; P<0.001).
Observational (n=479)
Does elevated GDF-15 predict death or recurrent MI in unselected patients with acute chest pain?
GDF-15 levels on admission provide independent prognostic information for death or recurrent MI in patients with acute chest pain, improving risk stratification beyond clinical characteristics, ECG, and troponin.
Absolute Event Rate: 12.6% vs 1.3%
p-value: p=<0.001
AIMS: Growth-differentiation factor-15 (GDF-15) has emerged as a biomarker of increased mortality and recurrent myocardial infarction (MI) in patients diagnosed with non-ST-elevation acute coronary syndrome. We explored the usefulness of GDF-15 for early risk stratification in 479 unselected patients with acute chest pain. METHODS AND RESULTS: Sixty-nine per cent of the patients presented with GDF-15 levels above the previously defined upper reference limit (1200 ng/L). The risks of the composite endpoint of death or (recurrent) MI after 6 months were 1.3, 5.1, and 12.6% in patients with normal (1800 ng/L) levels of GDF-15 on admission, respectively (P < 0.001). By multivariable analysis that included clinical characteristics, ECG findings, peak cardiac troponin I levels within 2 h (cTnI(0-2 h)), N-terminal pro-B-type natriuretic peptide, C-reactive protein, and cystatin C, GDF-15 remained an independent predictor of the composite endpoint. The ability of the ECG combined with peak cTnI(0-2 h) to predict the composite endpoint was markedly improved by addition of GDF-15 (c-statistic, 0.74 vs. 0.83; P < 0.001). CONCLUSION: GDF-15 improves risk stratification in unselected patients with acute chest pain and provides prognostic information beyond clinical characteristics, the ECG, and cTnI.
Eggers et al. (2008) conducted an observational in acute chest pain (n=479). Growth-differentiation factor-15 (GDF-15) vs. Normal GDF-15 levels (<1200 ng/L) was evaluated on composite endpoint of death or (recurrent) MI (p=<0.001). Addition of GDF-15 to ECG and peak cTnI improved the prediction of 6-month death or recurrent MI in patients with acute chest pain (c-statistic 0.83 vs 0.74; P<0.001).