Plasma growth differentiation factor 15 predicts first-ever stroke in hypertensive patients.

Abstract

Growth differentiation factor 15 (GDF-15) is a relatively new biomarker that predicts adverse stroke outcomes. However, the association of GDF-15 with first-ever stroke in hypertensive patients has not yet been evaluated. The objective of this study was to evaluate the clinical implications of plasma GDF-15 on the development of first-ever stroke in patients with hypertension.In total, 254 patients with hypertension without a history of stroke were included from March 2010 to August 2010 and followed up until June 2013. The baseline circulating GDF-15 was determined by enzyme-linked immunosorbent assays.During a follow-up of 3.0 ± 0.6 years, 22 (8.7%) first-ever strokes were identified, including 12 ischemic strokes and 10 intracerebral hemorrhages (ICH). According to tertiles of GDF-15, survival free of first-ever stroke was lower in the highest tertile of GDF-15 (log-rank P = 0.001). By backward stepwise Cox-regression analysis, adjusted for age, gender, diabetes mellitus, hyperlipidemia, hypertension stage, body mass index, cigarette smoking, anti-hypertensive drugs, and uric acid, every 100 pg/mL-increase in plasma of GDF-15 predicted an 11% greater risk of first-ever stroke (hazard ratios [HR]: 1.11, 95% confidence interval [CI]: 1.03-1.20, P = 0.010) and an 18% increase in ischemic stroke risk (HR: 1.18, 95% CI: 1.07-1.30, P = 0.001). Receiver operating characteristic analysis indicated that GDF-15 had reasonable accuracy to predict first-ever stroke (area under curve = 0.73, 95% CI: 0.62-0.83, P < 0.001).This study identifies that GDF-15 is an independent predictor of first-ever stroke, especially for ischemic stroke in the patients with hypertension.

• Authors: Xiaojian Wang, Ling Zhu, Yan Wu, Kai Sun, Ming Su, Liping Yu, Jingzhou Chen, Weiju Li, Jing Yang, Zuyi Yuan, Rutai Hui
• Journal: Medicine (Medicine (Baltimore)) Vol. 95 Issue 30 Pg. e4342 (Jul 2016) ISSN: 1536-5964 [Electronic] United States
• PMID: 27472718 (Publication Type: Journal Article)

Chemical References

• Biomarkers
• GDF15 protein, human
• Growth Differentiation Factor 15

Topics

• Aged
• Biomarkers (blood)
• Cerebral Infarction (blood, diagnosis, mortality)
• China
• Disease-Free Survival
• Enzyme-Linked Immunosorbent Assay
• Female
• Follow-Up Studies
• Growth Differentiation Factor 15 (blood)
• Humans
• Hypertension (blood, diagnosis, mortality)
• Male
• Middle Aged
• Predictive Value of Tests
• Proportional Hazards Models
• Reference Values
• Stroke (blood, diagnosis, mortality)