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High-Intensity Statin Treatment Is Associated With Reduced Growth Differentiation Factor-15 in Patients With Coronary
Konrad Stępień1,2, Michał Ząbczyk1,3, Joanna Natorska1,3
1Department of Thromboembolic Disorders, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland.
Insights
High-intensity statin therapy significantly reduces Growth Differentiation Factor-15 (GDF-15) levels in patients with coronary artery disease (CAD). This reduction is primarily linked to statins' anti-inflammatory effects, not just lipid-lowering.
Area of Science:
- Cardiology
- Biomarkers
- Pharmacology
Background:
- Growth differentiation factor-15 (GDF-15) is elevated in coronary artery disease (CAD).
- The impact of intensive statin therapy on GDF-15 levels in advanced CAD patients was previously unexplored.
- This study investigates the association between high-intensity statin treatment and GDF-15 levels.
Purpose of the Study:
- To determine if high-intensity statin therapy is associated with changes in GDF-15 levels in patients with advanced CAD.
- To explore the relationship between GDF-15, C-reactive protein (CRP), and lipid profiles under statin treatment.
Main Methods:
- A secondary analysis of an observational cohort of 102 CAD patients.
- GDF-15 and C-reactive protein (CRP) levels were measured before and after a median of 7 months of high-intensity statin therapy (atorvastatin 80mg or rosuvastatin 40mg).
- Thrombin generation and fibrinolysis inhibitors were also assessed; no concurrent control group was used.
Main Results:
- Baseline GDF-15 levels correlated with age and CRP, but not lipid profiles.
- High-intensity statin therapy led to a 17.8% reduction in GDF-15 (p=0.006) and a 46.4% reduction in CRP (p<0.001).
- Lower GDF-15 levels were observed in patients achieving target LDL-C levels (<1.8 mmol/L and <1.4 mmol/L), and GDF-15 reduction was associated with CRP lowering, not solely lipid changes.
Conclusions:
- High-dose statin therapy is associated with decreased GDF-15 levels in CAD patients.
- The observed reduction in GDF-15 is largely attributed to the anti-inflammatory properties of statins.
- Age, baseline GDF-15, and baseline CRP were independent predictors of follow-up GDF-15 levels.
Background:
Growth differentiation factor-15 (GDF-15) is upregulated in coronary artery disease (CAD). The relationship of intensive statin therapy with circulating GDF-15 levels has not been explored yet. In the current secondary analysis of an observational cohort, we investigated whether high-intensity statin treatment is associated with GDF-15 in patients with advanced CAD.
Methods:
In 102 CAD patients we measured GDF-15 levels before and after median 7 [6-8] months from initiation atorvastatin 80 mg/day (n = 63, 61.8%) or rosuvastatin 40 mg/day (n = 39, 38.2%). At the two time points we also determined C-reactive protein (CRP), thrombin generation and fibrinolysis inhibitors. There was no concurrent control group.
Results:
At baseline GDF-15 levels (median 942; interquartile range 639-1284 pg/mL) were associated solely with age (R = 0.567, p < 0.001) and CRP (R = 0.464, p < 0.001), but not with lipid profile. On high-intensity statin therapy GDF-15 reduction by 17.8% was observed (p = 0.006), which was associated with CRP lowering by 46.4% (R = 0.788, p < 0.001), but not with changes in total cholesterol (by 17.6%) and low-density lipoprotein cholesterol (LDL-C) (by 28.1%). However, GDF-15 levels were lower by 28.5% (p < 0.001) and 18.9% (p = 0.013) in 43 patients (42.2%) who achieved the target LDL-C < 1.8 mmol/L and 19 (18.6%) with LDL-C < 1.4 mmol/L, respectively, as compared to the remainder. The type of statin was not associated with follow-up GDF-15. Age (p = 0.029), baseline GDF-15 (p < 0.001) and CRP (p < 0.001), but not LDL-C, were independently associated with follow-up GDF-15.
Conclusions:
We demonstrated that high-dose statin therapy is associated with lower GDF-15 in CAD patients and this effect is largely related to the anti-inflammatory properties of statins.
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