Abstract:
BACKGROUND:Growth differentiation factor 15 (GDF-15) is a marker of cell senescence. Age is a well-known determinant of GDF-15 levels, yet no study has analyzed the relationship between geriatric conditions and GDF-15. We hypothesize that geriatric conditions reflecting biological age might be stronger determinants of GDF-15 than chronological age in elderly patients with acute coronary syndrome. METHODS:A total of 208 patients (mean age = 78.3 ± 7.0 years) were included. Prior to discharge, a thorough geriatric assessment was performed and GDF-15 measured. Predictors of GDF-15 (transformed by its natural logarithm) were determined with linear regression. Furthermore, Cox regression was used for the analysis of all-cause mortality. The median follow-up was 728 days. RESULTS:Median GDF-15 concentration was 2432 pg/ml. In multivariate analysis, frailty (Fried score, p = 0.001), and comorbidity (Charlson index, p = 0.003) were independent determinants of lnGDF-15 while age was not significant (p = 0.17). Other covariates included in the model were male gender (p = 0.017), diabetes (p = 0.169), Killip class ≥2 (p = 0.046) and glomerular filtration rate (p = 0.001). The Fried score and Charlson index provided significant incremental value in the R2 model (0.362 vs 0.447; p = 0.0001). A total of 66 (32%) patients died. LnGDF-15 was a significant mortality predictor (HR = 1.82, 95% CI 1.12-2.94, p = 0.015) along with the Fried score (p = 0.013) and the Charlson index (p = 0.030). CONCLUSIONS:Geriatric conditions are strong determinants of GDF-15 levels on top of age in acute coronary syndromes. Furthermore, GDF-15 was associated with mortality independently of geriatric status. Geriatric assessment and GDF-15 are complementary tools.
journal_name
Int J Cardioljournal_title
International journal of cardiologyauthors
Sanchis J,Ruiz V,Bonanad C,Sastre C,Ruescas A,Díaz M,Rodríguez E,Valero E,García-Blas S,Carratalá A,Núñez E,Núñez Jdoi
10.1016/j.ijcard.2019.05.034subject
Has Abstractpub_date
2019-09-01 00:00:00pages
15-20eissn
0167-5273issn
1874-1754pii
S0167-5273(19)31276-8journal_volume
290pub_type
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