Towards a multi-marker prognostic strategy in acute heart failure: a role for GDF-15

Detalhes bibliográficos
Autor(a) principal: Bettencourt, Paulo
Data de Publicação: 2018
Outros Autores: Ferreira-Coimbra, João, Rodrigues, Pedro, Marques, Pedro, Moreira, Helena, Pinto, Maria João, Guimarães, João Tiago, Lourenço, Patrícia
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://hdl.handle.net/10400.26/27792
Resumo: AIMS: Growth differentiation factor (GDF)-15 mirrors inflammation and oxidative stress in cardiovascular diseases. Brain natriuretic peptide (BNP) is associated with cardiomyocyte stretch in heart failure (HF). The objective of this study was to evaluate the prognostic impact of plasma GDF-15 and BNP in acute HF. METHODS AND RESULTS: We studied a subgroup of patients prospectively recruited in an acute HF registry (follow-up: 2 years; endpoint: all-cause mortality). Cox regression multivariate models were built to study the association of GDF-15 and mortality. Further cross-classification according to discharge GDF-15 (mean) and BNP (mean) and association with mortality was studied. We studied 158 patients: seventy-nine were male, mean age was 75 years, 55.1% had left ventricular ejection fraction < 40%, mean discharge BNP was 1000 pg/mL, and mean GDF-15 was 3013 ng/mL. Higher BNP and GDF-15 predicted 2-year mortality. Patients with GDF-15 ≥ 3000 ng/mL had a multivariate adjusted 2-year death risk of 1.86 (1.08-3.18). Patients discharged with both BNP and GDF-15 above the mean had an adjusted hazard ratio of 4.33 (2.07-9.06) when compared with those with both <mean. CONCLUSIONS: Higher GDF-15 associated with worse prognosis in acute HF independently of BNP. When both biomarkers GDF-15 and BNP were elevated at discharge, the 2-year mortality risk increased over four-fold. Biomarkers related to different pathophysiological pathways can provide incremental prognostic information in acute HF.
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spelling Towards a multi-marker prognostic strategy in acute heart failure: a role for GDF-15GDF-15Heart failureMortalityNatriuretic peptidesPrognosisAIMS: Growth differentiation factor (GDF)-15 mirrors inflammation and oxidative stress in cardiovascular diseases. Brain natriuretic peptide (BNP) is associated with cardiomyocyte stretch in heart failure (HF). The objective of this study was to evaluate the prognostic impact of plasma GDF-15 and BNP in acute HF. METHODS AND RESULTS: We studied a subgroup of patients prospectively recruited in an acute HF registry (follow-up: 2 years; endpoint: all-cause mortality). Cox regression multivariate models were built to study the association of GDF-15 and mortality. Further cross-classification according to discharge GDF-15 (mean) and BNP (mean) and association with mortality was studied. We studied 158 patients: seventy-nine were male, mean age was 75 years, 55.1% had left ventricular ejection fraction < 40%, mean discharge BNP was 1000 pg/mL, and mean GDF-15 was 3013 ng/mL. Higher BNP and GDF-15 predicted 2-year mortality. Patients with GDF-15 ≥ 3000 ng/mL had a multivariate adjusted 2-year death risk of 1.86 (1.08-3.18). Patients discharged with both BNP and GDF-15 above the mean had an adjusted hazard ratio of 4.33 (2.07-9.06) when compared with those with both <mean. CONCLUSIONS: Higher GDF-15 associated with worse prognosis in acute HF independently of BNP. When both biomarkers GDF-15 and BNP were elevated at discharge, the 2-year mortality risk increased over four-fold. Biomarkers related to different pathophysiological pathways can provide incremental prognostic information in acute HF.John Wiley and SonsRepositório ComumBettencourt, PauloFerreira-Coimbra, JoãoRodrigues, PedroMarques, PedroMoreira, HelenaPinto, Maria JoãoGuimarães, João TiagoLourenço, Patrícia2019-02-12T13:19:34Z2018-01-01T00:00:00Z2018-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.26/27792engBettencourt P, Ferreira-Coimbra J, Rodrigues P, Marques P, Moreira H, Pinto MJ, Guimarães JT, Lourenço P. ESC Heart Fail. 2018 Dec;5(6):1017-1022.2055-5822doi: 10.1002/ehf2.12301info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2022-09-20T11:08:16Zoai:comum.rcaap.pt:10400.26/27792Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T15:49:03.857703Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Towards a multi-marker prognostic strategy in acute heart failure: a role for GDF-15
title Towards a multi-marker prognostic strategy in acute heart failure: a role for GDF-15
spellingShingle Towards a multi-marker prognostic strategy in acute heart failure: a role for GDF-15
Bettencourt, Paulo
GDF-15
Heart failure
Mortality
Natriuretic peptides
Prognosis
title_short Towards a multi-marker prognostic strategy in acute heart failure: a role for GDF-15
title_full Towards a multi-marker prognostic strategy in acute heart failure: a role for GDF-15
title_fullStr Towards a multi-marker prognostic strategy in acute heart failure: a role for GDF-15
title_full_unstemmed Towards a multi-marker prognostic strategy in acute heart failure: a role for GDF-15
title_sort Towards a multi-marker prognostic strategy in acute heart failure: a role for GDF-15
author Bettencourt, Paulo
author_facet Bettencourt, Paulo
Ferreira-Coimbra, João
Rodrigues, Pedro
Marques, Pedro
Moreira, Helena
Pinto, Maria João
Guimarães, João Tiago
Lourenço, Patrícia
author_role author
author2 Ferreira-Coimbra, João
Rodrigues, Pedro
Marques, Pedro
Moreira, Helena
Pinto, Maria João
Guimarães, João Tiago
Lourenço, Patrícia
author2_role author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Repositório Comum
dc.contributor.author.fl_str_mv Bettencourt, Paulo
Ferreira-Coimbra, João
Rodrigues, Pedro
Marques, Pedro
Moreira, Helena
Pinto, Maria João
Guimarães, João Tiago
Lourenço, Patrícia
dc.subject.por.fl_str_mv GDF-15
Heart failure
Mortality
Natriuretic peptides
Prognosis
topic GDF-15
Heart failure
Mortality
Natriuretic peptides
Prognosis
description AIMS: Growth differentiation factor (GDF)-15 mirrors inflammation and oxidative stress in cardiovascular diseases. Brain natriuretic peptide (BNP) is associated with cardiomyocyte stretch in heart failure (HF). The objective of this study was to evaluate the prognostic impact of plasma GDF-15 and BNP in acute HF. METHODS AND RESULTS: We studied a subgroup of patients prospectively recruited in an acute HF registry (follow-up: 2 years; endpoint: all-cause mortality). Cox regression multivariate models were built to study the association of GDF-15 and mortality. Further cross-classification according to discharge GDF-15 (mean) and BNP (mean) and association with mortality was studied. We studied 158 patients: seventy-nine were male, mean age was 75 years, 55.1% had left ventricular ejection fraction < 40%, mean discharge BNP was 1000 pg/mL, and mean GDF-15 was 3013 ng/mL. Higher BNP and GDF-15 predicted 2-year mortality. Patients with GDF-15 ≥ 3000 ng/mL had a multivariate adjusted 2-year death risk of 1.86 (1.08-3.18). Patients discharged with both BNP and GDF-15 above the mean had an adjusted hazard ratio of 4.33 (2.07-9.06) when compared with those with both <mean. CONCLUSIONS: Higher GDF-15 associated with worse prognosis in acute HF independently of BNP. When both biomarkers GDF-15 and BNP were elevated at discharge, the 2-year mortality risk increased over four-fold. Biomarkers related to different pathophysiological pathways can provide incremental prognostic information in acute HF.
publishDate 2018
dc.date.none.fl_str_mv 2018-01-01T00:00:00Z
2018-01-01T00:00:00Z
2019-02-12T13:19:34Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://hdl.handle.net/10400.26/27792
url http://hdl.handle.net/10400.26/27792
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv Bettencourt P, Ferreira-Coimbra J, Rodrigues P, Marques P, Moreira H, Pinto MJ, Guimarães JT, Lourenço P. ESC Heart Fail. 2018 Dec;5(6):1017-1022.
2055-5822
doi: 10.1002/ehf2.12301
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv John Wiley and Sons
publisher.none.fl_str_mv John Wiley and Sons
dc.source.none.fl_str_mv reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron:RCAAP
instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron_str RCAAP
institution RCAAP
reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
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