PMID- 37620152 OWN - NLM STAT- Publisher LR - 20231014 IS - 2055-5822 (Electronic) IS - 2055-5822 (Linking) VI - 10 IP - 5 DP - 2023 Oct TI - GDF-15 at admission predicts cardiovascular death, heart failure, and bleeding outcomes in patients with CAD. PG - 3123-3132 LID - 10.1002/ehf2.14484 [doi] AB - AIMS: We aimed to investigate the independent associations between growth differentiation factor 15 (GDF-15) level at admission and cardiovascular (CV) death, thrombotic events, heart failure (HF), and bleeding outcomes in patients with coronary artery disease (CAD). METHODS AND RESULTS: We measured the plasma concentrations of GDF-15 centrally in patients from the BIomarker-based Prognostic Assessment for patients with Stable angina and acute coronary Syndrome (BIPass) registry, which consecutively enrolled patients with CAD from November 2017 to September 2019 at five tertiary hospitals in China. The outcomes included CV death, thrombotic events [myocardial infarction (MI) and ischaemic stroke], HF events [acute HF during hospitalization and hospitalization for HF post-discharge (A/H HF) and cardiogenic shock], and bleeding outcomes [non-coronary artery bypass grafting-related major bleeding and clinically significant bleeding (CSB)] during the 12 month follow-up period after hospitalization. Among 6322 patients with CAD 65.4% male, median age 63.7 [inter-quartile range (IQR)] 56.0-70.1 years, the median concentration of plasma GDF-15 at admission was 1091 (IQR 790.5-1635.0) ng/L. Higher concentrations of GDF-15 were associated with an increased risk of CV death [hazard ratio (HR) 1.98, 95% confidence interval (CI) 1.35-2.88, P < 0.001], A/H HF (HR 2.69, 95% CI 1.92-3.77, P < 0.001), cardiogenic shock (HR 1.46, 95% CI 1.04-2.05, P = 0.029), and CSB (HR 1.48, 95% CI 1.22-1.79, P < 0.001), but not for MI or stroke, after adjusting for clinical risk factors and prognostic biomarkers. Adding GDF-15 to the model with risk factors and biomarkers improved the net reclassification for CV death, A/H HF, cardiogenic shock, and CSB. CONCLUSIONS: In patients with CAD, admission levels of GDF-15 were associated with an increased 1 year risk of CV death, HF, and bleeding outcomes, but not with thrombotic events. GDF-15 may be a prognostic biomarker for CV death, HF, and bleeding outcomes and could be used to refine the risk assessment of these specific clinical outcomes. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04044066. CI - (c) 2023 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology. FAU - Wang, Jiali AU - Wang J AD - Department of Emergency and Chest Pain Center, Qilu Hospital of Shandong University, Jinan, China. AD - Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Qilu Hospital of Shandong University, Jinan, China. AD - Key Laboratory of Emergency and Critical Care Medicine of Shandong Province, Qilu Hospital of Shandong University, Jinan, China. AD - Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital of Shandong University, Jinan, China. FAU - Zhang, Tao AU - Zhang T AD - Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Qilu Hospital of Shandong University, Jinan, China. AD - Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China. FAU - Xu, Feng AU - Xu F AD - Department of Emergency and Chest Pain Center, Qilu Hospital of Shandong University, Jinan, China. AD - Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Qilu Hospital of Shandong University, Jinan, China. AD - Key Laboratory of Emergency and Critical Care Medicine of Shandong Province, Qilu Hospital of Shandong University, Jinan, China. AD - Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital of Shandong University, Jinan, China. FAU - Gao, Wei AU - Gao W AD - Department of Cardiology, Peking University Third Hospital, Beijing, China. FAU - Chen, Ming AU - Chen M AD - Department of Cardiology, Peking University First Hospital, Beijing, China. FAU - Zhu, Huadong AU - Zhu H AD - Department of Emergency, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China. FAU - Xu, Jun AU - Xu J AD - Department of Emergency, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China. FAU - Yin, Xinxin AU - Yin X AD - Department of Emergency and Chest Pain Center, Qilu Hospital of Shandong University, Jinan, China. AD - Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Qilu Hospital of Shandong University, Jinan, China. AD - Key Laboratory of Emergency and Critical Care Medicine of Shandong Province, Qilu Hospital of Shandong University, Jinan, China. AD - Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital of Shandong University, Jinan, China. FAU - Pang, Jiaojiao AU - Pang J AD - Department of Emergency and Chest Pain Center, Qilu Hospital of Shandong University, Jinan, China. AD - Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Qilu Hospital of Shandong University, Jinan, China. AD - Key Laboratory of Emergency and Critical Care Medicine of Shandong Province, Qilu Hospital of Shandong University, Jinan, China. AD - Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital of Shandong University, Jinan, China. FAU - Zhang, Song AU - Zhang S AD - Department of Emergency and Chest Pain Center, Qilu Hospital of Shandong University, Jinan, China. AD - Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Qilu Hospital of Shandong University, Jinan, China. AD - Key Laboratory of Emergency and Critical Care Medicine of Shandong Province, Qilu Hospital of Shandong University, Jinan, China. AD - Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital of Shandong University, Jinan, China. FAU - Wei, Mengke AU - Wei M AD - Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Qilu Hospital of Shandong University, Jinan, China. AD - Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China. FAU - Chen, Jiahao AU - Chen J AD - Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China. FAU - Liu, Ying AU - Liu Y AD - Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China. FAU - Yu, Xuezhong AU - Yu X AD - Department of Emergency, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China. FAU - Chew, Derek P AU - Chew DP AD - Department of Cardiovascular Medicine, Flinders University, Adelaide, Australia. FAU - Chen, Yuguo AU - Chen Y AD - Department of Emergency and Chest Pain Center, Qilu Hospital of Shandong University, Jinan, China. AD - Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Qilu Hospital of Shandong University, Jinan, China. AD - Key Laboratory of Emergency and Critical Care Medicine of Shandong Province, Qilu Hospital of Shandong University, Jinan, China. AD - Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital of Shandong University, Jinan, China. LA - eng SI - ClinicalTrials.gov/NCT04044066 GR - 2020YFC1512700/National Key Research and Development Program of China/ GR - 2020YFC1512705/National Key Research and Development Program of China/ GR - 2020YFC1512703/National Key Research and Development Program of China/ GR - 2018FY100600/National Science and Technology Fundamental Resources Investigation Project/ GR - 2018FY100602/National Science and Technology Fundamental Resources Investigation Project/ GR - 2021ZLGX02/Key Research and Development Program of Shandong Province/ GR - 2021SFGC0503/Key Research and Development Program of Shandong Province/ GR - tspd20181220/Taishan Pandeng Scholar Program of Shandong Province/ GR - tsqn20161065/Taishan Young Scholar Program of Shandong Province/ GR - tsqn201812129/Taishan Young Scholar Program of Shandong Province/ GR - Youth Top-Talent Project of National Ten Thousand Talents Plan and Qilu Young Scholar Program/ GR - 2021SDUCRCA005/ECCM Program of Clinical Research Center of Shandong University/ PT - Journal Article DEP - 20230824 PL - England TA - ESC Heart Fail JT - ESC heart failure JID - 101669191 SB - IM PMC - PMC10567639 OTO - NOTNLM OT - Biomarker OT - Clinical outcomes OT - Coronary artery disease OT - Growth differentiation factor 15 OT - Prognostic value COIS- The authors declare that they have no conflicts of interest. EDAT- 2023/08/25 00:42 MHDA- 2023/08/25 00:42 PMCR- 2023/08/24 CRDT- 2023/08/24 21:42 PHST- 2023/06/01 00:00 [revised] PHST- 2023/01/23 00:00 [received] PHST- 2023/07/04 00:00 [accepted] PHST- 2023/08/25 00:42 [pubmed] PHST- 2023/08/25 00:42 [medline] PHST- 2023/08/24 21:42 [entrez] PHST- 2023/08/24 00:00 [pmc-release] AID - EHF214484 [pii] AID - 10.1002/ehf2.14484 [doi] PST - ppublish SO - ESC Heart Fail. 2023 Oct;10(5):3123-3132. doi: 10.1002/ehf2.14484. Epub 2023 Aug 24.