scholarly journals Growth Differentiation Factor 15 Predicts All-Cause Morbidity and Mortality in Stable Coronary Heart Disease

2017 ◽  
Vol 63 (1) ◽  
pp. 325-333 ◽  
Author(s):  
Emil Hagström ◽  
Claes Held ◽  
Ralph A H Stewart ◽  
Philip E Aylward ◽  
Andrzej Budaj ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Troponin T ◽  
High Sensitivity ◽  
Prognostic Biomarkers ◽  
Morbidity And Mortality ◽  
Growth Differentiation Factor 15 ◽  
End Point ◽  
Differentiation Factor ◽  
Stable Coronary Heart Disease

Abstract BACKGROUND Higher growth differentiation factor 15 (GDF-15) concentrations are associated with cardiovascular (CV) and non-CV morbidity and mortality. However, information on associations between GDF-15 and the risk of specific CV and non-CV events in stable coronary heart disease (CHD) patients is limited. METHODS In 14 577 patients with stable CHD participating in the Stabilization of Atherosclerotic Plaque by Initiation of Darapladib Therapy Trial (STABILITY), GDF-15 and other prognostic biomarkers (N-terminal pro–B-type natriuretic peptide, high-sensitivity troponin T, cystatin C, and high-sensitivity C-reactive protein) were measured. In adjusted Cox regression models, the associations between GDF-15 and the composite CV end point [CV death, myocardial infarction (MI), and stroke], as well as other CV and non-CV events, were assessed. RESULTS The median concentration (interquartile range) of GDF-15 at baseline was 1253 (915–1827) ng/L. The hazard ratio for the composite end point for the highest compared to the lowest quartile of GDF-15 was 1.8 (95% CI, 1.5–2.2); for CV death, 2.63 (1.9–3.6); for sudden death, 3.06 (1.9–4.8); for heart failure (HF) death, 4.3 (1.3–14); for cancer death, 2.5 (1.3–4.7); for hospitalization for HF, 5.8 (3.2–10); for MI 1.4 (95% CI, 1.1–1.9); and for stroke, 1.8 (95% CI, 1.1–2.8). After adjustment for other prognostic biomarkers, GDF-15 remained significantly associated with all outcomes except for MI. CONCLUSIONS In stable CHD, GDF-15 was independently associated with CV, non-CV, and cancer mortality, as well as with MI and stroke. When also adjusting for other prognostic biomarkers, the associations to all fatal and nonfatal events were maintained except for MI. Information on GDF-15, therefore, might be helpful when assessing the risk of adverse outcomes in patients with stable CHD. ClinicalTrials.gov Identifier: NCT00799903

scholarly journals Cardiac Troponin T Measured by a High-Sensitivity Assay Predicts Recurrent Cardiovascular Events in Stable Coronary Heart Disease Patients with 8-Year Follow-up

2012 ◽  
Vol 58 (8) ◽  
pp. 1215-1224 ◽  
Author(s):  
Wolfgang Koenig ◽  
Lutz P Breitling ◽  
Harry Hahmann ◽  
Bernd Wüsten ◽  
Hermann Brenner ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Cystatin C ◽  
Troponin T ◽  
Plasma Concentrations ◽  
High Sensitivity ◽  
Net Reclassification Improvement ◽  
Stable Coronary Heart Disease ◽  
Chd Risk Factors

Abstract BACKGROUND The clinical relevance of slightly increased circulating troponin concentrations in patients with stable coronary heart disease (CHD) several weeks after an acute event or CABG has not been fully evaluated. METHODS Baseline plasma concentrations of troponin T were measured with a high-sensitivity assay (hs-cTnT) (Roche Elecsys) in a cohort of 1050 CHD patients from 30 to 70 years of age. The prognostic value of hs-cTnT on a combined cardiovascular disease (CVD) end point after adjustment for covariates was determined with Cox proportional hazards modeling. RESULTS The median hs-cTnT concentration was 10.9 ng/L (interquartile range, 5.1–18.9 ng/L). Increased hs-cTnT concentrations were associated with an older age, history of hypertension and diabetes, more advanced coronary artery disease, and other CHD risk factors. Furthermore, hs-cTnT concentration was strongly correlated with N-terminal pro–B-type natriuretic peptide (NT-proBNP) and cystatin C (ρ = 0.61, and ρ = 0.32, respectively; both P values <0.0001). During a median follow-up of 8.1 years, 150 patients (14.3%) experienced a secondary CVD event. In a multivariate model, hs-cTnT was associated with a hazard ratio (HR) for secondary events of 2.83 (95% CI, 1.68–4.79) when the extreme quartiles were compared. Further adjustment for cystatin C, NT-proBNP, and C-reactive protein attenuated this association only slightly (HR, 2.27; 95% CI, 1.31–3.95); P for trend < 0.002). ROC curve analysis of a clinical model that added hs-cTnT to a baseline model showed nonsignificant improvement in the area under the curve (0.69 vs 0.67), whereas the net reclassification improvement was 17.2% (P = 0.029). CONCLUSIONS Slightly increased hs-cTnT concentrations in stable CHD patients are associated with several cardiovascular disorders and predict long-term CVD events.

scholarly journals Elevated circulating high-sensitivity cardiac troponin t and cardiac remodeling in obesity

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jiaojiao Huang ◽  
Ming Liu ◽  
Enyong Su ◽  
Peng Yu ◽  
Hong Jiang ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Myocardial Injury ◽  
Troponin T ◽  
High Sensitivity ◽  
Coronary Intervention ◽  
Continuous Variables ◽  
Chi Square ◽  
Chi Square Test ◽  
The Impact

Abstract Background It is well established that body mass index (BMI) and troponins are independently associated. However, whether the obesity could cause myocardial injury independent of coronary heart disease (CHD) remains unclear. This study focuses on the relationship between BMI and troponins, and whether this relationship is being attenuated when CHD is accounted for. Methods In populations without acute ischemic events, 383 patients with coronary artery stenosis less than 75% were included, that is, people who have not yet reached the indications for coronary intervention, and of them 70 patients being obese according to BMI ≥ 28 kg/m2. Continuous variables were represented as mean ± SD or median(inter quartile range[IQR]). Chi-square test was adopted for categorical data. Correlations between variables were evaluated by Spearman analysis, multiple regression or logistic regression. Results The circulating hs-cTnT level was higher in the obese group [8(6,11) ng/L vs. 6(4,9) ng/L; p < 0.001). In subgroup analysis based on the presence or absence of coronary heart disease(CHD), the adjusted β(95%CI) for circulating hs-cTnT exhibited a proportional relationship with BMI when the non-obesity were defined as the reference[β; 2.22(95%CI, 0.73 to 3.71) in non-CHD, 5.58(95%CI, 0.70 to 10.46) in CHD, p < 0.05]. Additionally, the degree of coronary stenosis has shown a positive correlation with circulating hs-cTnT (rho = 0.1162; p < 0.05). Conclusion When CHD is taken into account, obesity is independently associated to the elevation of circulating hs-cTnT, a biomarker of myocardial injury, potentially indicating the impact of obesity on non-ischemic subclinical myocardial injury.

scholarly journals High-Sensitivity Cardiac Troponin T Levels and Secondary Events in Outpatients With Coronary Heart Disease From the Heart and Soul Study

2013 ◽  
Vol 173 (9) ◽  
pp. 763 ◽  
Author(s):  
Alexis L. Beatty ◽  
Ivy A. Ku ◽  
Robert H. Christenson ◽  
Christopher R. DeFilippi ◽  
Nelson B. Schiller ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Cardiac Troponin ◽  
Troponin T ◽  
High Sensitivity ◽  
Cardiac Troponin T

scholarly journals Growth Differentiation Factor 15 Provides Prognostic Information Superior to Established Cardiovascular and Inflammatory Biomarkers in Unselected Patients Hospitalized With COVID-19

Circulation ◽  
2020 ◽  
Vol 142 (22) ◽  
pp. 2128-2137 ◽  
Author(s):  
Peder L. Myhre ◽  
Christian Prebensen ◽  
Heidi Strand ◽  
Ragnhild Røysland ◽  
Christine M. Jonassen ◽  
...  
Keyword(s):  
Prognostic Value ◽  
Troponin T ◽  
Inflammatory Biomarkers ◽  
Receiver Operating Curve ◽  
Prognostic Information ◽  
Unique Identifier ◽  
Growth Differentiation Factor 15 ◽  
End Point ◽  
Differentiation Factor ◽  
Lower Oxygen

Background: Growth differentiation factor 15 (GDF-15) is a strong prognostic marker in sepsis and cardiovascular disease (CVD). The prognostic value of GDF-15 in coronavirus disease 2019 (COVID-19) is unknown. Methods: Consecutive, hospitalized patients with laboratory-confirmed infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and symptoms of COVID-19 were enrolled in the prospective, observational COVID Mechanisms Study. Biobank samples were collected at baseline, day 3 and day 9. The primary end point was admission to the intensive care unit or death during hospitalization, and the prognostic performance of baseline and serial GDF-15 concentrations were compared with that of established infectious disease and cardiovascular biomarkers. Results: Of the 123 patients enrolled, 35 (28%) reached the primary end point; these patients were older, more often had diabetes, and had lower oxygen saturations and higher National Early Warning Scores on baseline. Baseline GDF-15 concentrations were elevated (>95th percentile in age-stratified healthy individuals) in 97 (79%), and higher concentrations were associated with detectable SARS-CoV-2 viremia and hypoxemia (both P <0.001). Patients reaching the primary end point had higher concentrations of GDF-15 (median, 4225 [IQR, 3197–5972] pg/mL versus median, 2187 [IQR, 1344–3620] pg/mL, P <0.001). The area under the receiver operating curve was 0.78 (95% CI, 0.70–0.86). The association between GDF-15 and the primary end point persisted after adjusting for age, sex, race, body mass index, estimated glomerular filtration rate, previous myocardial infarction, heart failure, and atrial fibrillation ( P <0.001) and was superior and incremental to interleukin-6, C-reactive protein, procalcitonin, ferritin, D-dimer, cardiac troponin T, and N-terminal pro-B-type natriuretic peptide. Increase in GDF-15 from baseline to day 3 was also greater in patients reaching the primary end point (median, 1208 [IQR, 0–4305] pg/mL versus median, –86 [IQR, –322 to 491] pg/mL, P <0.001). Conclusions: GDF-15 is elevated in the majority of patients hospitalized with COVID-19, and higher concentrations are associated with SARS-CoV-2 viremia, hypoxemia, and worse outcome. The prognostic value of GDF-15 was additional and superior to established cardiovascular and inflammatory biomarkers. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT04314232.

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