Abstract:
AIMS:Growth-differentiation factor-15 (GDF-15) has emerged as a biomarker of increased mortality and recurrent myocardial infarction (MI) in patients diagnosed with non-ST-elevation acute coronary syndrome. We explored the usefulness of GDF-15 for early risk stratification in 479 unselected patients with acute chest pain. METHODS AND RESULTS:Sixty-nine per cent of the patients presented with GDF-15 levels above the previously defined upper reference limit (1200 ng/L). The risks of the composite endpoint of death or (recurrent) MI after 6 months were 1.3, 5.1, and 12.6% in patients with normal (<1200 ng/L), moderately elevated (1200-1800 ng/L), or markedly elevated (>1800 ng/L) levels of GDF-15 on admission, respectively (P < 0.001). By multivariable analysis that included clinical characteristics, ECG findings, peak cardiac troponin I levels within 2 h (cTnI(0-2 h)), N-terminal pro-B-type natriuretic peptide, C-reactive protein, and cystatin C, GDF-15 remained an independent predictor of the composite endpoint. The ability of the ECG combined with peak cTnI(0-2 h) to predict the composite endpoint was markedly improved by addition of GDF-15 (c-statistic, 0.74 vs. 0.83; P < 0.001). CONCLUSION:GDF-15 improves risk stratification in unselected patients with acute chest pain and provides prognostic information beyond clinical characteristics, the ECG, and cTnI.
journal_name
Eur Heart Jjournal_title
European heart journalauthors
Eggers KM,Kempf T,Allhoff T,Lindahl B,Wallentin L,Wollert KCdoi
10.1093/eurheartj/ehn339subject
Has Abstractpub_date
2008-10-01 00:00:00pages
2327-35issue
19eissn
0195-668Xissn
1522-9645pii
ehn339journal_volume
29pub_type
杂志文章,多中心研究abstract::Pulsed Doppler tracings of the mitral inflow are often proposed to describe left ventricular function during filling in hypertensive patients. The tracings are determined by the complex interaction of left atrial pressure and left ventricular relaxation, diastolic compliance and contractility of the left atrium. They ...
journal_title:European heart journal
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