Towards a multi-marker prognostic strategy in acute heart failure: a role for GDF-15
Autor(a) principal: | |
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Data de Publicação: | 2018 |
Outros Autores: | , , , , , , |
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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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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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 |
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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) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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1799130356392132608 |