scholarly journals Growth Differentiation Factor-15 in the Early Diagnosis and Risk Stratification of Patients with Acute Chest Pain

2012 ◽  
Vol 58 (2) ◽  
pp. 441-449 ◽  
Author(s):  
Nora Schaub ◽  
Tobias Reichlin ◽  
Raphael Twerenbold ◽  
Miriam Reiter ◽  
Stephan Steuer ◽  
...  
Keyword(s):  
Chest Pain ◽  
Early Diagnosis ◽  
Risk Stratification ◽  
Acute Chest Pain ◽  
Final Diagnosis ◽  
Growth Differentiation Factor 15 ◽  
Differentiation Factor ◽  
All Cause Mortality ◽  
Integrated Discrimination Improvement

Abstract BACKGROUND Growth differentiation factor-15 (GDF-15) is a stress-responsive marker that might aid in the early diagnosis and risk stratification of patients with suspected acute myocardial infarction (AMI). METHODS In a prospective, international multicenter study, GDF-15, high-sensitivity cardiac troponin T (hs-cTnT), and B-type natriuretic peptide (BNP) were measured in 646 unselected patients presenting to the emergency department with acute chest pain. The final diagnosis was adjudicated by 2 independent cardiologists. The primary prognostic end point was all-cause mortality during a median follow-up of 26 months. RESULTS AMI was the adjudicated final diagnosis in 115 patients (18%). GDF-15 concentrations at presentation were significantly higher in AMI patients compared to patients with other diagnoses. The diagnostic accuracy of GDF-15 at presentation for the diagnosis of AMI as quantified by the area under the ROC curve (AUC) was lower (AUC 0.69, 95% CI 0.64–0.74) compared to hs-cTnT (AUC 0.96, 95% CI 0.94–0.98, P < 0.001) and BNP (AUC 0.74, 95% CI 0.69–0.80, P = 0.02). A total of 55 deaths occurred during follow-up. GDF-15 predicted all-cause mortality independently of and more accurately than hs-cTnT [AUC 0.85 (95% CI 0.81–0.90) vs 0.77 (95% CI 0.72–0.83), P = 0.002] and BNP (AUC 0.75, 95% CI 0.68–0.82, P = 0.007). Net reclassification improvement was 0.15 (P = 0.01), and the absolute integrated discrimination improvement was 0.07, yielding a relative integrated discrimination improvement of 0.36 (P = 0.07). CONCLUSIONS GDF-15 predicts all-cause mortality in unselected patients with acute chest pain independently of and more accurately than hs-cTnT and BNP. However, GDF-15 does not seem to help in the early diagnosis of AMI.

scholarly journals Markers of Plaque Instability in the Early Diagnosis and Risk Stratification of Acute Myocardial Infarction

2012 ◽  
Vol 58 (1) ◽  
pp. 246-256 ◽  
Author(s):  
Nora Schaub ◽  
Tobias Reichlin ◽  
Christophe Meune ◽  
Raphael Twerenbold ◽  
Philip Haaf ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
Risk Stratification ◽  
Cardiac Troponin ◽  
Troponin T ◽  
Acute Chest Pain ◽  
High Sensitivity ◽  
Final Diagnosis ◽  
Cardiac Troponin T ◽  
Plaque Instability

Abstract BACKGROUND Plaque erosion and plaque rupture occur early in the pathophysiology of acute myocardial infarction (AMI). We hypothesized that markers of plaque instability might be useful in the early diagnosis and risk stratification of AMI. METHODS In this multicenter study, we examined 4 markers of plaque instability, myeloperoxidase (MPO), myeloid-related protein 8/14 (MRP-8/14), pregnancy-associated plasma protein-A (PAPP-A), and C-reactive protein (CRP) in 398 consecutive patients presenting to the emergency department with acute chest pain and compared them to normal and high-sensitivity cardiac troponin T (cTnT and hs-cTnT). The final diagnosis was adjudicated by 2 independent cardiologists. Primary prognostic end point was death during a median follow-up of 27 months. RESULTS The adjudicated final diagnosis was AMI in 76 patients (19%). At emergency department presentation, concentrations of all 4 biomarkers of plaque instability were significantly higher in patients with AMI than in patients with other diagnoses. However, their diagnostic accuracy as quantified by the area under the ROC curve (AUC) was low (MPO 0.63, MRP-8/14 0.65, PAPP-A 0.62, CRP 0.59) and inferior to both normal and high-sensitivity cardiac troponin T (cTnT 0.88, hs-cTnT 0.96; P < 0.001 for all comparisons). Thirty-nine patients (10%) died during follow-up. Concentrations of MPO, MRP-8/14, and CRP were higher in nonsurvivors than in survivors and predicted all-cause mortality with moderate accuracy. CONCLUSIONS Biomarkers of plaque instability do not seem helpful in the early diagnosis of AMI but may provide some incremental value in the risk stratification of patients with acute chest pain.

scholarly journals Growth-differentiation factor-15 for risk stratification in patients with acute chest pain

2008 ◽  
Vol 29 (23) ◽  
pp. 2947-2947 ◽  
Author(s):  
A. Bouzas-Mosquera ◽  
J. Peteiro ◽  
J. M. Vazquez-Rodriguez ◽  
N. Alvarez-Garcia
Keyword(s):  
Chest Pain ◽  
Risk Stratification ◽  
Acute Chest Pain ◽  
Growth Differentiation Factor 15 ◽  
Differentiation Factor

scholarly journals Growth-differentiation factor-15 for early risk stratification in patients with acute chest pain

2008 ◽  
Vol 29 (19) ◽  
pp. 2327-2335 ◽  
Author(s):  
K. M. Eggers ◽  
T. Kempf ◽  
T. Allhoff ◽  
B. Lindahl ◽  
L. Wallentin ◽  
...  
Keyword(s):  
Chest Pain ◽  
Risk Stratification ◽  
Acute Chest Pain ◽  
Growth Differentiation Factor 15 ◽  
Early Risk ◽  
Differentiation Factor

B-type Natriuretic Peptide in the Early Diagnosis and Risk Stratification of Acute Chest Pain

2011 ◽  
Vol 124 (5) ◽  
pp. 444-452 ◽  
Author(s):  
Philip Haaf ◽  
Tobias Reichlin ◽  
Nils Corson ◽  
Raphael Twerenbold ◽  
Miriam Reiter ◽  
...  
Keyword(s):  
Chest Pain ◽  
Early Diagnosis ◽  
Risk Stratification ◽  
Natriuretic Peptide ◽  
Acute Chest Pain

scholarly journals Adding stress biomarkers to high sensitivity troponin measurements increases precision and efficacy of rapid rule out protocols for NSTEMI

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
I Restan ◽  
O.T Steiro ◽  
H.L Tjora ◽  
J Langoergen ◽  
T Omland ◽  
...  
Keyword(s):  
Chest Pain ◽  
Acute Chest Pain ◽  
High Sensitivity ◽  
Final Diagnosis ◽  
Public Institution ◽  
P Value ◽  
Funding Source ◽  
University Hospitals ◽  
High Sensitivity Troponin ◽  
Rule Out

Abstract Background NSTEMI may be ruled out in patients presenting with acute chest pain based on low baseline high sensitivity troponin (cTn) at admission. This procedure is limited by a low expected frequency of ruled out non-cardiac chest pain (NCCP) patients. Purpose To investigate if stress-induced biomarkers (glucose or copeptin) combined with cTn can increase the rate of NCCP ruled out without an unacceptable increase in incorrectly ruled out NSTEMI. Method 971 patients with suspected NSTE-ACS were included. Final diagnosis was adjudicated by two independent cardiologists using clinical data including routine cTnT. Additionally, baseline cTnI, cTnI from Singulex Clarity System (cTnI(sgx)), copeptin and glucose were measured. Diagnostic performance to rule out NSTEMI was compared between the ESC rule out algorithms for cTnT and cTnI(Abbott), a local cTnI(sgx) algorithm and different combinations of cTn with copeptin or glucose Results Median age 61 years, 60% male. 13% had NSTEMI, 12% had UAP and 60% NCCP. Distribution of copeptin and glucose concentrations (NSTEMI and NCCP) is shown in figure 1. Copeptin and cTnT produces an algorithm with lower miss rate for NSTEMI, increased rule out rate for NCCP and significantly higher AUC (DeLong test, p value <0.001) compared to the ESC algorithm (Table 1). cTnI(sgx) and copeptin showed higher rule out for NCCP and higher AUC (p value <0.001), however an increased rule out rate for NSTEMIs. Combining cTnI(Abbott) and glucose gave a similar miss rate for NSTEMI as ESC, but increased rule out rate for NCCP and higher AUC (p value <0.001). Conclusion Combining cTnT or cTnI(sgx) with copeptin; or cTnI with glucose, improves diagnostic precision and efficacy of rule out protocols for NSTEMI in patients presenting with acute chest pain. Figure 1 Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): Western Norway Regional Health Authority; Haukeland and Stavanger University Hospitals

scholarly journals PROGNOSTIC VALUE OF GROWTH DIFFERENTIATION FACTOR 15(GDF-15) IN MYOCARDIAL INFARCTION

2021 ◽  
Vol 14 (2) ◽  
pp. 52-55
Author(s):  
ALEXANDRA A. SABIRZYANOVA ◽  
◽  
ALBERT S. GALYVICH ◽  
Keyword(s):  
Myocardial Infarction ◽  
Risk Stratification ◽  
Prognostic Value ◽  
Practical Medicine ◽  
Growth Differentiation Factor 15 ◽  
Differentiation Factor

Determining the prognosis of a disease and risk stratification are significant issues in practical medicine. Aim.The aim of the study was to estimate the prognostic value of growth differentiation factor 15 (GDF-15) in myocardial infarction according to the literature.

Associations between elevated growth differentiation factor-15 and sarcopenia among community-dwelling older adults

2021 ◽  
Author(s):  
Miji Kim ◽  
Jeremy D Walston ◽  
Chang Won Won
Keyword(s):  
Older Adults ◽  
Community Dwelling ◽  
Cross Sectional ◽  
Baseline Serum ◽  
Growth Differentiation Factor 15 ◽  
Differentiation Factor ◽  
Study Participants ◽  
Community Dwelling Older Adults ◽  
Prospective Analyses

Abstract Background Growth differentiation factor 15 (GDF-15) is associated with disease progression, mitochondrial dysfunction, and mortality. Elevated GDF-15 level was recently reported to be associated with poorer physical performance in healthy adults. However, the association between serum GDF-15 level and sarcopenia in community-dwelling older adults has not been well characterized. Methods We conducted cross-sectional (n = 929) and two-year prospective analyses (n = 788) among participants aged 70–84 years enrolled in the Korean Frailty and Aging Cohort Study. Participants with an estimated glomerular filtration rate of <60 mL/min/1.73 m 2 were excluded. Appendicular lean mass was measured using dual-energy X-ray absorptiometry. Sarcopenia status was determined according to the Asian Working Group for Sarcopenia-2019 algorithm. Results At baseline, 16.6% of the participants had sarcopenia. Median GDF-15 concentration was higher in the sarcopenic group than in the non-sarcopenic group (1221 pg/mL vs. 1019 pg/mL, p<0.001). In the multivariate analysis adjusted for cardiometabolic risk and biological factors, the highest GDF-15 tertile (≥1245 pg/mL) had an increased likelihood of sarcopenia (odds ratio, 1.96; 95% confidence interval, 1.16–3.33) than the lowest tertile (<885 pg/mL). During the two-year follow-up period, 67 (10.1%) individuals without sarcopenia at baseline developed sarcopenia. There were no significant associations between baseline serum GDF-15 levels and incident sarcopenia or its components (all p>0.05). Conclusions Elevated GDF-15 was associated with prevalent sarcopenia but not able to predict incident sarcopenia in the 2-year follow-up. Further studies are needed to explore the pathophysiological roles of GDF-15 in the development of sarcopenia.

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