1. Growth differentiation factor-15 combined with N-terminal prohormone of brain natriuretic peptide increase 1-year prognosis prediction value for patients with acute heart failure: a prospective cohort study
- Author
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Ji Hao, Iokfai Cheang, Li Zhang, Kai Wang, Hui-Min Wang, Qian-Yun Wu, Yan-Li Zhou, Fang Zhou, Dong-Jie Xu, Hai-Feng Zhang, Wen-Ming Yao, Xin-Li Li, and Yi Cui
- Subjects
Adult ,Male ,medicine.medical_specialty ,Growth Differentiation Factor 15 ,medicine.drug_class ,lcsh:Medicine ,Growth differentiation factor-15 ,Gastroenterology ,03 medical and health sciences ,0302 clinical medicine ,Predictive Value of Tests ,Internal medicine ,Natriuretic Peptide, Brain ,medicine ,Natriuretic peptide ,Clinical endpoint ,Humans ,Prospective Studies ,Prospective cohort study ,Aged ,Proportional Hazards Models ,Heart Failure ,business.industry ,Proportional hazards model ,lcsh:R ,General Medicine ,Original Articles ,Middle Aged ,medicine.disease ,Brain natriuretic peptide ,Prognosis ,Confidence interval ,Peptide Fragments ,ROC Curve ,030220 oncology & carcinogenesis ,Heart failure ,Predictive value of tests ,Acute Disease ,Female ,business ,N-terminal pro-B type natriuretic peptide ,030217 neurology & neurosurgery ,Biomarkers - Abstract
Background: Clinical assessment and treatment guidance for heart failure depends on a variety of biomarkers. The objective of this study was to investigate the prognostic predictive value of growth differentiation factor-15 (GDF-15) and N-terminal prohormone of brain natriuretic peptide (NT-proBNP) in assessing hospitalized patients with acute heart failure (AHF). Methods: In total, 260 patients who were admitted for AHF in the First Affiliated Hospital of Nanjing Medical University were enrolled from April 2012 to May 2016. Medical history and blood samples were collected within 24 h after the admission. The primary endpoint was the all-cause mortality within 1 year. The patients were divided into survival group and death group based on the endpoint. With established mortality risk factors and serum GDF-15 level, receiver-operator characteristic (ROC) analyses were performed. Cox regression analyses were used to further analyze the combination values of NT-proBNP and GDF-15. Results: Baseline GDF-15 and NT-proBNP were significantly higher amongst deceased than those in survivors (P < 0.001). In ROC analyses, area under curve (AUC) for GDF-15 to predict 1-year mortality was 0.707 (95% confidence interval [CI]: 0.648–0.762, P < 0.001), and for NT-proBNP was 0.682 (95% CI: 0.622–0.738, P < 0.001). No statistically significant difference was found between the two markers (P = 0.650). Based on the optimal cut-offs (GDF-15: 4526.0 ng/L; NT-proBNP: 1978.0 ng/L), the combination of GDF-15 and NT-proBNP increased AUC for 1-year mortality prediction (AUC = 0.743, 95% CI: 0.685–0.795, P < 0.001). Conclusions: GDF-15, as a prognostic marker in patients with AHF, is not inferior to NT-proBNP. Combining the two markers could provide an early recognition of high-risk patients and improve the prediction values of AHF long-term prognosis. Clinical trial registration: ChiCTR-ONC-12001944, http://www.chictr.org.cn. Key words: Growth differentiation factor-15; Heart failure; N-terminal pro-B type natriuretic peptide; Prognosis
- Published
- 2019