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Updated: Sep 26, 2026
Coronary Progenitor Cells and Soluble Biomarkers in Cardiovascular Prognosis after Coronary Angioplasty
Published on: January 28, 2020
Diagnostic and prognostic value of growth differentiation factor 15 in suspected functionally relevant coronary
Fiona Nafaa1, Gabrielle Huré1, Seval Kul2
1Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Heart Center, University Hospital Basel, University of Basel, Switzerland; GREAT Network, Rome, Italy.
Background:
The rapid and accurate non-invasive diagnosis of significant and functionally relevant coronary artery disease is a crucial yet unmet clinical need. Growth differentiation factor 15 (GDF-15) may be involved in the development of coronary artery disease. We aimed to evaluate the diagnostic and prognostic value of GDF-15 in patients with suspected functionally relevant coronary artery disease.
Methods:
In this prospective cohort study, consecutive patients underwent myocardial perfusion imaging with single-photon-emission computed tomography, and coronary angiography plus fractional flow reserve, when available. Functionally relevant coronary artery disease was centrally adjudicated. Prognostic endpoints included all-cause mortality and cardiovascular death.
Results:
Among 3,379 patients eligible for this analysis (median age 68 years, 33% female, 44% known coronary artery disease), 1,160 patients (34%) had adjudicated functionally relevant coronary artery disease. GDF-15 concentrations were significantly higher in patients with the adjudicated diagnosis (1,325 ng/L (95%CI, 1,258-1,364) versus 1,041 ng/L (95%CI, 1,009-1,074), p<0.001). However, the diagnostic accuracy of GDF-15 for identifying functionally relevant coronary artery disease was modest, with an area under the curve (AUC) of 0.598. Combined with clinical judgment, GDF-15 significantly increased the diagnostic accuracy (AUC 0.659). During a 5-year follow-up, 437 deaths (14%) occurred, of which 231 were cardiovascular. GDF-15 had very high prognostic accuracy for all-cause and cardiovascular death (e.g. time-dependent AUC 0.815 and 0.834 at 2 years), at least comparable to high-sensitivity cardiac troponin (hs-cTn)T, and higher than hs-cTnI.
Conclusion:
While GDF-15 has limited diagnostic utility, it exhibits high prognostic value in patients with suspected functionally relevant coronary artery disease.
