Abstract | BACKGROUND: METHODS AND RESULTS: Levels of GDF-15, CRP and Cystatin C were determined in three repeated measurements collected 5 years apart in the DAN-MONICA (Danish-Multinational MONitoring of trends and determinants in Cardiovascular disease) cohort (participants at baseline n = 3785). Cox regression models adjusted for cardiovascular risk factors revealed significantly increased hazard ratios (HR) for GDF-15 for incident HF 1.36 (HR per interquartile range (IQR) increase, 95% confidence interval (CI): 1.16; 1.59) and for death from CHD 1.51 (HR per IQR increase, 95% CI: 1.31, 1.75) (both with p<0.001). Joint modeling of time-to-event and longitudinal GDF-15 over a median 27-year follow-up period showed that the marker evolution was positively associated with death of CHD (HR per IQR increase 3.02 95% CI: (2.26, 4.04), p < 0.001) and HF (HR per IQR increase 2.12 95% CI: (1.54, 2.92), p<0.001). However using Cox models with follow-up time starting at the time of the third examination, serial measurement of GDF-15, modeled as changes between the measurements, did not improve prediction over that of the most recent measurement. CONCLUSIONS:
GDF-15 is a promising biomarker for prediction of HF and death due to CHD in the general population, which may provide prognostic information to already established clinical biomarkers. Repeated measurements of GDF-15 displayed only a slight improvement in the prediction of these endpoints compared to a single measurement.
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Authors | Nina Fluschnik, Francisco Ojeda, Tanja Zeller, Torben Jørgensen, Kari Kuulasmaa, Peter Moritz Becher, Christoph Sinning, Stefan Blankenberg, Dirk Westermann |
Journal | PloS one
(PLoS One)
Vol. 13
Issue 5
Pg. e0197497
( 2018)
ISSN: 1932-6203 [Electronic] United States |
PMID | 29771963
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Biomarkers
- Cystatin C
- GDF15 protein, human
- Growth Differentiation Factor 15
- C-Reactive Protein
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Topics |
- Adult
- Biomarkers
(blood)
- C-Reactive Protein
(metabolism)
- Coronary Disease
(blood, mortality, pathology)
- Cystatin C
(blood)
- Female
- Growth Differentiation Factor 15
(blood)
- Heart Failure
(blood, mortality, pathology)
- Humans
- Male
- Middle Aged
- Prognosis
- Proportional Hazards Models
- Prospective Studies
- Risk Factors
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