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The biomarker gdf 15 in a 5-year prediction of adverse outcomes in patients with acute coronary syndrome

Session Poster Session 3

Speaker Associate Professor Irina Vishnevskaya

Event : Heart Failure 2019

  • Topic : coronary artery disease, acute coronary syndromes, acute cardiac care
  • Sub-topic : Coronary Artery Disease – Pathophysiology and Mechanisms
  • Session type : Poster Session

Authors : IR Vyshnevska (Kharkiv,UA), MP Kopytsya (Kharkiv,UA)

Authors:
IR Vyshnevska1 , MP Kopytsya1 , 1Government institution“L.T. Malaya Therapy National institute of the National academy of medical sci - Kharkiv - Ukraine ,

Citation:

The search for an optimal biomarker that can significantly predict long-term prognosis in patients with an acute coronary syndrome (ACS) is still going. Growth differentiation factor 15 (GDF 15) is being actively studied.

Purpose: to determine the significance of GDF 15 in the prediction of 5-years adverse outcomes after acute coronary syndrome.

Methods: The study included 70 patients with different forms of ACS. The mean age was 61.8 ± 1.3 years (77% men and 23% women). They were admitted to the hospital from 2012 to 2013 and signed the informed consent. Among them, 54% of the patients with Q-wave myocardial infarction (Q-wave MI), 20% - with non-Q-wave myocardial infarction (non-Q-wave MI), 26% - unstable angina (UA). All patients underwent a baseline investigation which includes: standard electrocardiography, echocardiography, angiography, and determination of marker of myocardial necrosis – cardiac troponin I. In addition to that, the level of GDF 15 determined during the first day of hospitalization. The endpoint considered as all-cause mortality. 20% of patients died during 5-years follow-up. Long-term survival rates were calculated using the Kaplan-Meier method and compared using the log-rank test.

Results: There was a significant difference in GDF 15 serum level between patients who have died and those, who have survived during 5 years after ACS (p=0.0015). The effect of several variables of clinical, instrumental and laboratory status assessed on surviving patients. For the identification of the main risk factors for adverse outcome, we have used logistic regression (LR) method. We have found that GDF 15 (AUC 0.7; p=0.006; 95% Cl: 0.552 – 0.814) could independently predict mortality with sensitivity 80% and specificity 60%. GDF-15?
Conclusion: the biomarker GDF 15 is a strong and crucial predictor of 5-years mortality in patients with acute coronary syndrome. The measuring of this biomarker could be used in clinical practice to improve risk stratification during the first 24 hours after the event.

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