PMID- 17825714
OWN - NLM
STAT- MEDLINE
DCOM- 20070928
LR  - 20220330
IS  - 1558-3597 (Electronic)
IS  - 0735-1097 (Linking)
VI  - 50
IP  - 11
DP  - 2007 Sep 11
TI  - Prognostic utility of growth differentiation factor-15 in patients with chronic 
      heart failure.
PG  - 1054-60
AB  - OBJECTIVES: We explored the prognostic utility of growth differentiation factor 
      (GDF)-15 in patients with chronic heart failure (CHF). BACKGROUND: Growth 
      differentiation factor-15 is a stress-responsive member of the transforming 
      growth factor-beta cytokine superfamily. It has recently been observed that 
      patients with CHF have increased circulating levels of GDF-15. The relations of 
      GDF-15 to other biomarkers and to mortality in CHF have never been studied. 
      METHODS: Circulating levels of GDF-15 were determined by immunoradiometric assay 
      in 455 patients with CHF with a median left ventricular ejection fraction (LVEF) 
      of 32% (interquartile range 25% to 39%). RESULTS: The median GDF-15 level was 
      1,949 ng/l (interquartile range 1,194 to 3,577); 74.9% of the patients presented 
      with GDF-15 levels >1,200 ng/l, the upper limit of normal in healthy elderly 
      individuals. The GDF-15 levels were closely related to New York Heart Association 
      (NYHA) functional class and to amino-terminal pro-B-type natriuretic peptide 
      (NT-proBNP). The risk of death during follow-up increased with increasing 
      quartiles of GDF-15. Mortality rates at 48 months were 10.0%, 9.4%, 33.4%, and 
      56.2% in the respective quartiles (p < 0.001). After adjustment for clinical 
      variables and established biomarkers of adverse prognosis, including NT-proBNP, 
      renal dysfunction, anemia, and hyperuricemia, GDF-15 remained an independent 
      predictor of mortality (adjusted hazard ratio for 1 U in the Ln scale 2.26; 95% 
      confidence interval 1.52 to 3.37; p < 0.001). Growth differentiation factor 15 
      provided prognostic information in clinically relevant patient subgroups (defined 
      according to age, body mass index, heart failure etiology, concomitant medical 
      therapy, renal function, and the levels of hemoglobin and uric acid) and added 
      prognostic information to NYHA functional class, LVEF, and NT-proBNP. 
      CONCLUSIONS: Growth differentiation factor 15 is a new biomarker of the risk of 
      death in patients with CHF that provides prognostic information beyond 
      established clinical and biochemical markers.
FAU - Kempf, Tibor
AU  - Kempf T
AD  - Department of Cardiology and Angiology, Hannover Medical School, Hannover, 
      Germany.
FAU - von Haehling, Stephan
AU  - von Haehling S
FAU - Peter, Timo
AU  - Peter T
FAU - Allhoff, Tim
AU  - Allhoff T
FAU - Cicoira, Mariantonietta
AU  - Cicoira M
FAU - Doehner, Wolfram
AU  - Doehner W
FAU - Ponikowski, Piotr
AU  - Ponikowski P
FAU - Filippatos, Gerasimos S
AU  - Filippatos GS
FAU - Rozentryt, Piotr
AU  - Rozentryt P
FAU - Drexler, Helmut
AU  - Drexler H
FAU - Anker, Stefan D
AU  - Anker SD
FAU - Wollert, Kai C
AU  - Wollert KC
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20070824
PL  - United States
TA  - J Am Coll Cardiol
JT  - Journal of the American College of Cardiology
JID - 8301365
RN  - 0 (Biomarkers)
RN  - 0 (Bone Morphogenetic Proteins)
RN  - 0 (GDF15 protein, human)
RN  - 0 (Growth Differentiation Factor 15)
SB  - IM
CIN - J Am Coll Cardiol. 2007 Sep 11;50(11):1061-3. PMID: 17825715
MH  - Aged
MH  - Biomarkers/blood
MH  - Bone Morphogenetic Proteins/*blood
MH  - Cohort Studies
MH  - Female
MH  - Growth Differentiation Factor 15
MH  - Heart Failure/*blood/diagnosis/*mortality
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Predictive Value of Tests
MH  - Prognosis
MH  - Risk Factors
MH  - Survival Rate
EDAT- 2007/09/11 09:00
MHDA- 2007/09/29 09:00
CRDT- 2007/09/11 09:00
PHST- 2007/01/09 00:00 [received]
PHST- 2007/03/02 00:00 [revised]
PHST- 2007/04/01 00:00 [accepted]
PHST- 2007/09/11 09:00 [pubmed]
PHST- 2007/09/29 09:00 [medline]
PHST- 2007/09/11 09:00 [entrez]
AID - S0735-1097(07)02005-0 [pii]
AID - 10.1016/j.jacc.2007.04.091 [doi]
PST - ppublish
SO  - J Am Coll Cardiol. 2007 Sep 11;50(11):1054-60. doi: 10.1016/j.jacc.2007.04.091. 
      Epub 2007 Aug 24.