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Growth Differentiation Factor 15 Is Associated with Platelet Reactivity in Patients with Acute Coronary Syndrome

David Mutschlechner1, Maximilian Tscharre2,3, Patricia P Wadowski3

  • 1Department of Internal Medicine I, Cardiology and Intensive Care Medicine, Landesklinikum Mistelbach-Gänserndorf, 2130 Mistelbach, Austria.

Journal of Clinical Medicine
|February 25, 2023
PubMed

Insights

Growth Differentiation Factor (GDF)-15 is linked to reduced platelet aggregation in acute coronary syndrome (ACS) patients. Higher GDF-15 levels indicate lower platelet reactivity, particularly with ADP, suggesting a role in bleeding risk prediction.

Area of Science:

  • Cardiovascular Medicine
  • Hematology
  • Biomarkers

Background:

  • Bleeding events in acute coronary syndrome (ACS) patients increase mortality risk.
  • Growth Differentiation Factor (GDF)-15 is a known predictor of bleeding complications.
  • Understanding GDF-15's association with platelet reactivity is crucial for managing ACS patients on antiplatelet therapy.

Purpose of the Study:

  • To investigate the relationship between GDF-15 levels and on-treatment platelet reactivity.
  • To assess this association in ACS patients receiving prasugrel or ticagrelor after coronary stenting.
  • To determine if GDF-15 predicts platelet aggregation in response to various agonists.

Main Methods:

  • Measured platelet aggregation using multiple electrode aggregometry (MEA) with agonists like ADP, AA, TRAP, AYPGKF, and collagen.
  • Quantified GDF-15 levels using a commercial assay.
  • Analyzed correlations between GDF-15 and MEA results, including adjusted analyses.

Main Results:

  • GDF-15 showed inverse correlations with MEA responses to ADP, AA, and TRAP.
  • After adjustment, GDF-15 was significantly associated with TRAP-induced platelet aggregation.
  • Patients with low ADP-induced platelet reactivity had significantly higher GDF-15 levels.

Conclusions:

  • GDF-15 is inversely associated with TRAP-inducible platelet aggregation in ACS patients on modern antiplatelet therapy.
  • Elevated GDF-15 levels are observed in patients with low platelet reactivity to ADP.
  • GDF-15 may serve as a biomarker for predicting bleeding risk by reflecting platelet function in ACS.

Keywords:
acute coronary syndromegrowth differentiation factor 15platelet reactivityprasugrelticagrelor

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