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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

Ed. by Gillery, Philippe / Greaves, Ronda / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Payne, Deborah A. / Schlattmann, Peter


IMPACT FACTOR 2018: 3.638

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1437-4331
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Volume 57, Issue 7

Issues

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

Ferran Rueda
  • Department of Cardiology, Heart Institute, Germans Trias i Pujol University Hospital, Badalona (Barcelona), Spain
  • Department of Medicine, CIBERCV, Autonomous University of Barcelona, Barcelona, Spain
  • Other articles by this author:
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/ Josep Lupón
  • Department of Cardiology, Heart Institute, Germans Trias i Pujol University Hospital, Badalona (Barcelona), Spain
  • Department of Medicine, CIBERCV, Autonomous University of Barcelona, Barcelona, Spain
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/ Cosme García-García
  • Department of Medicine, CIBERCV, Autonomous University of Barcelona, Barcelona, Spain
  • Heart Institute, Germans Trias i Pujol University Hospital, Badalona (Barcelona), Spain
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/ German Cediel
  • Department of Medicine, CIBERCV, Autonomous University of Barcelona, Barcelona, Spain
  • Heart Institute, Germans Trias i Pujol University Hospital, Badalona (Barcelona), Spain
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ M. Cruz Aranda Nevado
  • Department of Medicine, CIBERCV, Autonomous University of Barcelona, Barcelona, Spain
  • Heart Institute, Germans Trias i Pujol University Hospital, Badalona (Barcelona), Spain
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  • De Gruyter OnlineGoogle Scholar
/ Judith Serra Gregori
  • Department of Medicine, CIBERCV, Autonomous University of Barcelona, Barcelona, Spain
  • Heart Institute, Germans Trias i Pujol University Hospital, Badalona (Barcelona), Spain
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/ Carlos Labata
  • Department of Medicine, CIBERCV, Autonomous University of Barcelona, Barcelona, Spain
  • Heart Institute, Germans Trias i Pujol University Hospital, Badalona (Barcelona), Spain
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/ Teresa Oliveras
  • Department of Medicine, CIBERCV, Autonomous University of Barcelona, Barcelona, Spain
  • Heart Institute, Germans Trias i Pujol University Hospital, Badalona (Barcelona), Spain
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/ Marc Ferrer
  • Department of Medicine, CIBERCV, Autonomous University of Barcelona, Barcelona, Spain
  • Heart Institute, Germans Trias i Pujol University Hospital, Badalona (Barcelona), Spain
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/ Oriol de Diego
  • Department of Medicine, CIBERCV, Autonomous University of Barcelona, Barcelona, Spain
  • Heart Institute, Germans Trias i Pujol University Hospital, Badalona (Barcelona), Spain
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/ Jordi Serra
  • Department of Medicine, CIBERCV, Autonomous University of Barcelona, Barcelona, Spain
  • Heart Institute, Germans Trias i Pujol University Hospital, Badalona (Barcelona), Spain
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/ Elena Revuelta López
  • Department of Medicine, CIBERCV, Autonomous University of Barcelona, Barcelona, Spain
  • Heart Institute, Germans Trias i Pujol University Hospital, Badalona (Barcelona), Spain
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/ Antoni Bayés-Genís
  • Corresponding author
  • Department of Medicine, CIBERCV, Autonomous University of Barcelona, Barcelona, Spain
  • Head, Heart Institute, Germans Trias i Pujol University Hospital, Carretera de Canyet s/n 08916, Badalona (Barcelona), Spain
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Published Online: 2019-02-01 | DOI: https://doi.org/10.1515/cclm-2018-1189

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.

This article offers supplementary material which is provided at the end of the article.

Keywords: biomarkers; growth differentiation factor 15; prognosis; ST-elevation myocardial infarction

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About the article

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


Received: 2018-11-05

Accepted: 2018-12-28

Published Online: 2019-02-01

Published in Print: 2019-06-26


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

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.

Employment or leadership: None declared.

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

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.


Citation Information: Clinical Chemistry and Laboratory Medicine (CCLM), Volume 57, Issue 7, Pages 1093–1101, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: https://doi.org/10.1515/cclm-2018-1189.

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