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Aims. Growth differentiation factor 15 (GDF15) shows potential predictive value in various cardiac conditions. We investigated relationships between GDF15 and clinical or procedural outcomes in patients with severe aortic stenosis undergoing transcatheter aortic valve implantation (TAVI) in order to propose clinically useful predictive risk stratification model. Methods. This prospective single-center registry enrolled 88 consecutive patients with severe symptomatic aortic stenosis treated with TAVI. Clinical parameters were collected and biomarkers including GDF-15 were measured within 24 h before TAVI. All relevant clinical outcomes according to the Valve Academic Research Consortium-2 were collected over the follow-up period. Results. The cohort included 52.3% of females. The mean age of study participants was 81 years; the mean Society of Thoracic Surgeons (STS) score and logistic EuroSCORE were 3.6% and 15.4%, respectively. The mortality over the entire follow-up period was 10.2%; no death was observed within the first 30 days following TAVI. Univariate analysis showed significant associations between GDF15 and mortality (P=0.0006), bleeding (P=0.0416) and acute kidney injury (P=0.0399). A standard multivariate logistic regression model showed GDF-15 as the only significant predictor of mortality (P=0.003); the odds ratio corresponding to an increase in GDF15 of 1000 pg/mL was 1.22. However, incremental predictive value was not observed when the STS score was combined with GDF15 in this predictive model. Conclusions. Based on our observations, preprocedural elevated GDF15 levels are associated with increased mortality and demonstrate their additional value in predicting adverse clinical outcomes in a TAVI population.

Aims: The study aimed at comparing two methods for evaluating thymidinekinase TK in serum - an older RIA method and novel DiviTum™ - in patients with MM and MGUS, and also comparing them with biochemical markers and degree of activity evaluated by imaging methods 99mTc-MIBI scintigraphy and 18F-FDG PET/CT. Methods: Serum thymidinekinase TK levels were evaluated by DiviTum™ and an RIA method (TK REA kit by Immunotech);The study analyzed correlation of TK activity in serum with biochemical markers reflecting activity of MM: β2-m, LDH, the ratio of kappa to lambda (κ/λ) free light chains and percentage of bone marrow plasma cells (BMPC). 99mTc-MIBI scintigraphy and 18F-FDG PET/CT were performed at the time of diagnosis. The degree of activity was expressed semiquantitatively. Scans were classified as 0 (normal activity), 1 (diffuse positivity) or 2 (focal positivity). Results: We found a strong positive correlation between TK in serum evaluated by DiviTum™ and by TK REA.. The DiviTum™ analytic method extended the detection range and was able to detect higher levels of TK than the RIA method. DiviTum™ technique found positive correlation with β2-m (r = 0.497) and LDH (r = 0.502) and moderate positive correlation with BMPC (r = 0.368). Significantly higher TK values measured by TK REA and DiviTum™ in the group of patients with MM (stages I, II or III) than in those with MGUS. Increased TK levels were observed in MIBI- or PET/CT-positive patients. Analysis of repeated measurements of TK in serum during treatment of MM patients found a correlation between change in TK measured by DiviTum™ and LDH during treatment. Conclusions: Analysis revealed a significant correlation between TK in serum and LDH, β2-m and BMPC. Increased levels of TK in serum were observed in MIBI- or PET/CT-positive patients. Combination of positivity of imaging methods which can localize active tumor lesions and increased levels of TK in serum can have an impact on decision-making and optimization of the therapeutic approach.