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Acute-phase dynamics and prognostic value of growth differentiation factor-15 in ST-elevation myocardial infarction

  • Ferran Rueda , Josep Lupón , Cosme García-García , German Cediel , M. Cruz Aranda Nevado , Judith Serra Gregori , Carlos Labata , Teresa Oliveras , Marc Ferrer , Oriol de Diego , Jordi Serra , Elena Revuelta López and Antoni Bayés-Genís EMAIL logo
Published/Copyright: February 1, 2019
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Clinical Chemistry and Laboratory Medicine (CCLM)
From the journal Clinical Chemistry and Laboratory Medicine (CCLM) Volume 57 Issue 7

Abstract

Background

Growth differentiation factor 15 (GDF-15) in ST-elevation myocardial infarction (STEMI) is prognostic in first-generation radioimmunoassays. We examined GDF-15 temporal dynamics in STEMI and its predictive value using a first fully automated GDF-15 electrochemiluminescence assay.

Methods

In this prospective study, circulating GDF-15 concentration was measured at admission (0 h), 12 h and 24 h in 1026 consecutive STEMI patients treated between February 2011 and May 2016 with primary percutaneous coronary intervention. GDF-15 dynamics (0 h, 12 h, 24 h) and predictive value (30 days and 3 years) were examined.

Results

Median GDF-15 concentration was 1443 pg/mL at 0 h, 1731 pg/mL at 12 h and 1510 pg/mL at 24 h (p<0.001). During follow-up, 94 patients died (9.2%) and 154 (15.0%) were hospitalized. GDF-15 was a strong predictor of 30-day mortality (hazard ratio [HR] 1.76, 95% confidence interval [CI], 1.33–2.34 at 0 h; HR 2.99 [95% CI, 2.18–4.09] at 12 h, and HR 1.97 [95% CI, 1.47–2.63] at 24 h) in multivariable Cox proportional hazards models. GDF-15 improved discrimination and reclassification of a clinical risk model. GDF-15 was also associated with 3-year mortality (HR 1.31 [95% CI, 1.04–1.65] at 0 h, HR 1.42 [95% CI, 1.10–1.84] at 12 h, and HR 1.51 [95% CI, 1.16–1.96] at 24 h) and 3-year composite of mortality and cardiovascular hospitalization (HR 1.17 [95% CI, 1.01–1.37] at 0 h, HR 1.20 [95% CI, 1.02–1.42] at 12 h, and HR 1.27 [95% CI, 1.08–1.50] at 24 h).

Conclusions

GDF-15 peaked at 12 h and remained elevated at 24 h in STEMI. GDF-15 measurement during the first 24 h in STEMI is valuable for predicting especially short- but also long-term outcomes, and may be a useful addition to risk stratification.

Keywords: biomarkers; growth differentiation factor 15; prognosis; ST-elevation myocardial infarction
Corresponding author: Antoni Bayés-Genís, MD, PhD, FESC, Head, Heart Institute, Germans Trias i Pujol University Hospital, Carretera de Canyet s/n 08916, Badalona (Barcelona), Spain; and Department of Medicine, CIBERCV, Autonomous University of Barcelona, Barcelona, Spain
aPhD Program in Internal Medicine, Autonomous University of Barcelona, Barcelona, Spain

  1. Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Research funding: Roche Diagnostics supported this research by running the GDF-15, hs-TnT and NT-proBNP assays free of charge. However, the authors are solely responsible for the design and conduct of the study, all analyses and the drafting and editing of the manuscript.

  3. Employment or leadership: None declared.

  4. Honorarium: AB-G and JL received honoraria for lectures and advisory boards from Roche Diagnostics.

  5. Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

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Supplementary Material

The online version of this article offers supplementary material (https://doi.org/10.1515/cclm-2018-1189).

Received: 2018-11-05
Accepted: 2018-12-28
Published Online: 2019-02-01
Published in Print: 2019-06-26

©2019 Walter de Gruyter GmbH, Berlin/Boston

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https://doi.org/10.1515/cclm-2018-1189
Keywords for this article
biomarkers; growth differentiation factor 15; prognosis; ST-elevation myocardial infarction

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. Epigenetics in cancer: a promising path to follow?
  4. Reviews
  5. The circulating miRNAs as diagnostic and prognostic markers
  6. Analytical barriers in clinical B-type natriuretic peptide measurement and the promising analytical methods based on mass spectrometry technology
  7. Mini Review
  8. Commutability of reference and control materials: an essential factor for assuring the quality of measurements in Laboratory Medicine
  9. EFLM Paper
  10. Preanalytical challenges – time for solutions
  11. General Clinical Chemistry and Laboratory Medicine
  12. Iron status determination in individuals with Helicobacter pylori infection: conventional vs. new laboratory biomarkers
  13. Harmonizing by reducing inter-run variability: performance evaluation of a quality assurance program for antinuclear antibody detection by indirect immunofluorescence
  14. Increased prevalence of anti-DFS70 antibodies in young females: experience from a large international multi-center study on blood donors
  15. Accuracy of determination of the glomerular filtration marker iohexol by European laboratories as monitored by external quality assessment
  16. Therapeutic drug monitoring (TDM) of 5-fluorouracil (5-FU): new preanalytic aspects
  17. Monitoring the effectiveness of hypothermia in perinatal asphyxia infants by urinary S100B levels
  18. Hematology and Coagulation
  19. Determination of haemoglobin derivatives in aged dried blood spot to estimate haematocrit
  20. Reference Values and Biological Variations
  21. A study of biological and lifestyle factors, including within-subject variation, affecting concentrations of growth differentiation factor 15 in serum
  22. Reference intervals for thyroid-stimulating hormone, free thyroxine, and free triiodothyronine in elderly Chinese persons
  23. Cancer Diagnostics
  24. Extracellular vesicle-associated miRNAs in ovarian cancer – design of an integrated NGS-based workflow for the identification of blood-based biomarkers for platinum-resistance
  25. Evaluating the diagnostic and prognostic value of serum long non-coding RNA CTC-497E21.4 in gastric cancer
  26. A pilot study of new promising non-coding RNA diagnostic biomarkers for early-stage colorectal cancers
  27. Cardiovascular Diseases
  28. Prognostic role of GDF-15 across the spectrum of clinical risk in patients with NSTE-ACS
  29. Acute-phase dynamics and prognostic value of growth differentiation factor-15 in ST-elevation myocardial infarction
  30. Diabetes
  31. Lipid profile and genetic status in a familial hypercholesterolemia pediatric population: exploring the LDL/HDL ratio
  32. Letters to the Editor
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  34. Need of a dedicated isotopic internal standard for accurate 3-epi-25(OH)D3 quantification by LC-MS/MS
  35. An unexpectedly prolonged severe hyperbilirubinemia in a patient with pre-existing hepatitis A: a role of genetic predisposition?
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  42. Requirement of a reference measurement system for the tissue factor-induced coagulation time and the international normalized ratio
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