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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
- Source :
- Chinese Medical Journal, Chinese Medical Journal, Vol 132, Iss 19, Pp 2278-2285 (2019)
- Publication Year :
- 2019
- Publisher :
- Wolters Kluwer Health, 2019.
-
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
- 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
Subjects
Details
- Language :
- English
- ISSN :
- 25425641 and 03666999
- Volume :
- 132
- Issue :
- 19
- Database :
- OpenAIRE
- Journal :
- Chinese Medical Journal
- Accession number :
- edsair.doi.dedup.....c75cfe7e921a9fb4711e1e4bdddc231d