Temporal Pattern of Growth Differentiation Factor-15 Protein After Acute Coronary Syndrome (From the BIOMArCS Study)
Temporal Pattern of Growth Differentiation Factor-15 Protein After Acute Coronary Syndrome (From the BIOMArCS Study)
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DOI：
10.1016/j.amjcard.2019.03.049
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发表时间：
2019-07-01
影响因子：
2.8
通讯作者：
Boersma, Eric
中科院分区：
文献类型：
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作者：
Buljubasic, Nermina;Vroegindewey, Maxime M.;Boersma, Eric
生长分化因子 15 (GDF-15) 已成为一种有前景的生物标志物，对急性冠脉综合征 (ACS) 具有很强的预测能力。然而，研究仅基于 ACS 事件急性期的单次测量。 ACS 后患者的 GDF-15 模式的长期表现尚不清楚。我们在多中心、前瞻性、观察性生物标志物研究 (BIOMArCS) 中对 844 名 ACS 患者进行了一项巢式病例对照研究。在发生 ACS 事件后，在 1 年的随访期间进行了高频血液采样。通过电化学发光免疫分析分批测定 37 例在 1 年随访期间复发事件的病例和 74 例无事件对照的 GDF-15。病例和对照的平均 +/- 标准差年龄为 66.9 +/- 11.3 岁，其中 81% 为男性。从 30 天起，患者表现出稳定的水平，病例组平均比对照组高 333（95% 置信区间 68 至 647）pg/mL（1704 vs 1371 pg/mL；p 值 0.013）。此外，在 30 天后，GDF-15 在病例和对照中均表现出较低的个体内变异性。总之，在 30 天至 1 年的随访期间，经历复发事件的 ACS 患者的 GDF-15 水平稳定且系统地高于具有其他类似临床特征的无事件患者。因此，出院后血液采样可能会在整个一年的过程中使用，以改善预后，然而，鉴于个体差异较小，重复采样的次数可能会受到限制。 (C) 2019 Elsevier Inc. 保留所有权利。
Growth differentiation factor-15 (GDF-15) has appeared as a promising biomarker with strong predictive abilities in acute coronary syndrome (ACS). However, studies are solely based on single measurements in the acute phase of an ACS event. The way GDF-15 patterns in post-ACS patients behave on the long term is largely unknown. We conducted a nested case-control study within our multicenter, prospective, observational biomarker study (BIOMArCS) of 844 ACS patients. Following an index ACS event, high-frequency blood sampling was performed during 1-year of follow-up. GDF-15 was determined batchwise by electrochemiluminescence immunoassays in 37 cases with a recurrent event during 1-year follow-up, and in 74 event-free controls. Cases and controls had a mean +/- standard deviation age of 66.9 +/- 11.3 years and 81% were men. From 30 days onwards, patients showed stable levels, which were on average 333 (95% confidence interval 68 to 647) pg/mL higher in cases than controls (1704 vs 1371 pg/mL; p value 0.013). Additionally, in the post 30-day period, GDF-15 showed low within-individual variability in both cases and controls. In conclusion, post-ACS patients experiencing a recurrent event had stable and systematically higher GDF-15 levels during 30-day to 1-year follow-up than their event-free counterparts with otherwise similar clinical characteristics. Thus, postdischarge blood sampling might be used throughout the course of 1 year to improve prognostication, whereas, in view of the low within-individual variation, the number of repeated sampling moments might be limited. (C) 2019 Elsevier Inc. All right reserved.