Growth Differentiation Factor-15 and Risk of Recurrent Events in Patients Stabilized After Acute Coronary Syndrome Observations From PROVE IT-TIMI 22
Growth Differentiation Factor-15 and Risk of Recurrent Events in Patients Stabilized After Acute Coronary Syndrome Observations From PROVE IT-TIMI 22
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DOI：
10.1161/atvbaha.110.213512
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发表时间：
2011-01-01
影响因子：
8.7
通讯作者：
Wollert, Kai C.
中科院分区：
文献类型：
--
作者：
Bonaca, Marc P.;Morrow, David A.;Wollert, Kai C.
研究生长分化因子（GDF）-15出院时的死亡，复发性心肌梗死（MI），充血性心力衰竭的风险评估，并确定这些风险是否可以修改statins.Methods和Results-GDF-15是一个转化生长因子β-相关的细胞因子诱导组织损伤。GDF-15浓度与急性冠脉综合征（ACS）患者的全因死亡率相关。我们在PROVE IT-TIMI 22中测量了3501例ACS后接受中度或强化他汀类药物治疗的患者的GDF-15。通过使用确定的截止点，GDF-15（< 1200、1200-1800和> 1800 ng/L）与2年死亡或MI风险相关（分别为5.7%、8.1%和15.1%; P < 0.001）、死亡（P < 0.001）、MI（P < 0.001）和充血性心力衰竭（P < 0.001）。校正年龄、性别、体重指数、糖尿病、高血压、吸烟、心肌梗死、合格事件、肾功能、B型利钠肽和高敏C反应蛋白后，GDF-15与死亡或心肌梗死风险相关（每ln增加GDF-15校正的风险比，2.1 [95%CI，1.6至2.9]; P < 0.001）、死亡（P <0.001）、MI（P < 0.001）和充血性心力衰竭（P < 0.001）。GDF-15和强化他汀类药物治疗对死亡或MI风险无显著相互作用（P = 0.24）。结论GDF-15与ACS后复发事件相关，独立于临床预测因子、B型利钠肽和高敏C反应蛋白。这一发现支持GDF-15作为ACS的预后标志物，并支持对改变这种风险的其他疗法的研究。（Arterioscler Thromb Vasc Biol.2011;31：203-210.）
Objective-To investigate growth differentiation factor (GDF)-15 at hospital discharge for assessment of the risk of death, recurrent myocardial infarction (MI), and congestive heart failure, and to determination of whether these risks can be modified by statins.Methods and Results-GDF-15 is a transforming growth factor-beta-related cytokine induced in response to tissue injury. GDF-15 concentration is associated with all-cause mortality in patients with acute coronary syndrome (ACS). We measured GDF-15 in 3501 patients after ACS, treated with moderate or intensive statin therapy in PROVE IT-TIMI 22. By using established cutoff points, GDF-15 (< 1200, 1200-1800, and > 1800 ng/L) was associated with 2-year risk of death or MI (5.7%, 8.1%, and 15.1%, respectively; P < 0.001), death (P < 0.001), MI (P < 0.001), and congestive heart failure (P < 0.001). After adjustment for age, sex, body mass index, diabetes mellitus, hypertension, smoking, MI, qualifying event, renal function, B-type natriuretic peptide, and high-sensitivity C-reactive protein, GDF-15 was associated with the risk of death or MI (adjusted hazard ratio per ln increase GDF-15, 2.1 [95% CI, 1.6 to 2.9]; P < 0.001), death (P < 0.001), MI (P < 0.001), and congestive heart failure (P < 0.001). There was no significant interaction between GDF-15 and intensive statin therapy for the risk of death or MI (P = 0.24 for the interaction).Conclusion-GDF-15 is associated with recurrent events after ACS, independent of clinical predictors, B-type natriuretic peptide, and high-sensitivity C-reactive protein. This finding supports GDF-15 as a prognostic marker in ACS and investigation of other therapies that modify this risk. (Arterioscler Thromb Vasc Biol. 2011;31:203-210.)