Growth-differentiation factor-15 improves risk stratification in ST-segment elevation myocardial infarction

Area of Science:

• Cardiology
• Biomarkers
• Myocardial Infarction Research

Background:

• Growth-differentiation factor-15 (GDF-15) is a cytokine induced by cardiac ischemia-reperfusion injury.
• Its prognostic utility in ST-segment elevation myocardial infarction (STEMI) requires further investigation.

Purpose of the Study:

• To explore the prognostic value of GDF-15 in patients with STEMI receiving fibrinolytic therapy.
• To determine if GDF-15 provides additional prognostic information beyond established biomarkers.

Main Methods:

• Circulating GDF-15 levels were measured using an immunoradiometric assay in 741 STEMI patients from the ASSENT-2 and ASSENT-plus trials.
• One-year mortality rates were analyzed in relation to GDF-15 levels.
• GDF-15's predictive power was assessed after adjusting for clinical variables, troponin T, and NT-proBNP.

Main Results:

• Approximately 72.7% of STEMI patients had GDF-15 levels above the normal range (> or =1200 ng/L).
• Increased GDF-15 levels correlated significantly with higher 1-year mortality (P < 0.001).
• GDF-15 independently predicted mortality and provided prognostic information across various patient subgroups and added value to troponin T and NT-proBNP.

Conclusions:

• GDF-15 is a novel and valuable prognostic biomarker in STEMI.
• It offers significant prognostic information that complements established clinical and biochemical markers for adverse outcomes.