Towards a multi-marker prognostic strategy in acute heart failure: a role for GDF-15.
Towards a multi-marker prognostic strategy in acute heart failure: a role for GDF-15.
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DOI：
10.1002/ehf2.12301
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发表时间：
2018-12
影响因子：
3.8
通讯作者：
Lourenço P
中科院分区：
文献类型：
--
作者：
Bettencourt P;Ferreira-Coimbra J;Rodrigues P;Marques P;Moreira H;Pinto MJ;Guimarães JT;Lourenço P
生长分化因子（GDF）‐15反映心血管疾病中的炎症和氧化应激。脑利钠肽（BNP）与心力衰竭（HF）时心肌细胞拉伸有关。本研究的目的是评估血浆GDF - 15和BNP对急性心衰患者预后的影响。我们研究了急性心衰登记处前瞻性招募的患者亚组（随访：2年；终点：全因死亡率）。建立Cox多元回归模型来研究GDF - 15与死亡率的关系。根据排出量GDF - 15（平均值）和BNP（平均值）进一步交叉分类并研究其与死亡率的关系。我们研究了158例患者：79例为男性，平均年龄75岁，55.1%左室射血分数< 40%，平均排出BNP为1000 pg/mL，平均GDF - 15为3013 ng/mL。较高的BNP和GDF - 15可预测2年死亡率。GDF - 15≥3000 ng/mL的患者多因素调整后2年死亡风险为1.86（1.08-3.18）。出院时BNP和GDF‐15均高于平均水平的患者与均<平均水平的患者相比，校正风险比为4.33（2.07-9.06）。高GDF - 15与急性心衰预后差相关，与BNP无关。当出院时生物标志物GDF - 15和BNP均升高时，2年死亡风险增加4倍以上。与不同病理生理途径相关的生物标志物可以为急性心衰提供渐进式的预后信息。
Growth differentiation factor (GDF)‐15 mirrors inflammation and oxidative stress in cardiovascular diseases. Brain natriuretic peptide (BNP) is associated with cardiomyocyte stretch in heart failure (HF). The objective of this study was to evaluate the prognostic impact of plasma GDF‐15 and BNP in acute HF. We studied a subgroup of patients prospectively recruited in an acute HF registry (follow‐up: 2 years; endpoint: all‐cause mortality). Cox regression multivariate models were built to study the association of GDF‐15 and mortality. Further cross‐classification according to discharge GDF‐15 (mean) and BNP (mean) and association with mortality was studied. We studied 158 patients: seventy‐nine were male, mean age was 75 years, 55.1% had left ventricular ejection fraction < 40%, mean discharge BNP was 1000 pg/mL, and mean GDF‐15 was 3013 ng/mL. Higher BNP and GDF‐15 predicted 2‐year mortality. Patients with GDF‐15 ≥ 3000 ng/mL had a multivariate adjusted 2‐year death risk of 1.86 (1.08–3.18). Patients discharged with both BNP and GDF‐15 above the mean had an adjusted hazard ratio of 4.33 (2.07–9.06) when compared with those with both <mean. Higher GDF‐15 associated with worse prognosis in acute HF independently of BNP. When both biomarkers GDF‐15 and BNP were elevated at discharge, the 2‐year mortality risk increased over four‐fold. Biomarkers related to different pathophysiological pathways can provide incremental prognostic information in acute HF.
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影响因子：
--
作者：
Januzzi, JL;Sakhuja, R;Lloyd-Jones, DM
通讯作者：
Lloyd-Jones, DM
影响因子：
20.1
作者：
Kempf, T;Eden, M;Wollert, KC
通讯作者：
Wollert, KC
影响因子：
37.8
作者：
Wang TJ;Wollert KC;Larson MG;Coglianese E;McCabe EL;Cheng S;Ho JE;Fradley MG;Ghorbani A;Xanthakis V;Kempf T;Benjamin EJ;Levy D;Vasan RS;Januzzi JL
通讯作者：
Januzzi JL
DOI：
10.1007/s12265-013-9459-y
发表时间：
2013-08-01
影响因子：
3.4
作者：
Januzzi, James L., Jr.
通讯作者：
Januzzi, James L., Jr.
影响因子：
37.8
作者：
Bettencourt, P;Azevedo, A;Ferreira, A
通讯作者：
Ferreira, A