Assessment of Growth Differentiation Factor 15 Levels on Coronary Flow in Patients with STEMI Undergoing Primary PCI
Growth Differentiation Factor-15 (GDF-15) is a strong predictor of decreased myocardial salvage and subsequent higher risk of death in patients with STEMI, but no information has been published regarding the association of GDF-15 levels with coronary blood flow in STEMI. We hypothesized that elevate...
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| Format: | Article |
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MDPI AG
2020-05-01
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| Series: | Diseases |
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| Online Access: | https://www.mdpi.com/2079-9721/8/2/16 |
| _version_ | 1797567077177884672 |
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| author | Orhan Dogdu |
| author_facet | Orhan Dogdu |
| author_sort | Orhan Dogdu |
| collection | DOAJ |
| description | Growth Differentiation Factor-15 (GDF-15) is a strong predictor of decreased myocardial salvage and subsequent higher risk of death in patients with STEMI, but no information has been published regarding the association of GDF-15 levels with coronary blood flow in STEMI. We hypothesized that elevated GDF-15 levels would be associated with impaired flow and perfusion in the setting of STEMI treated with primary PCI. Eighty consecutive patients who were admitted with STEMI within 6 h from symptom onset were enrolled in the study. Patients were divided into two groups based upon the Thrombolysis in Myocardial Infarction (TIMI) flow grade. Group 1 was defined as TIMI Grade 0, 1 and 2 flows. Angiographic success was defined as TIMI 3 flow (group 2). GDF-15 and high sensitive CRP were measured. Major adverse cardiac events (MACE) were defined as stent thrombosis, nonfatal myocardial infarction and in-hospital mortality. There were 35 patients (mean age 64 ± 11.8 and 20% female) in group 1 and 45 patients (mean age 66.8 ± 11.5 and 29% female) in group 2. GDF-15 and hs-CRP levels were significantly higher in group 1 than in group 2 (1670 ± 831pg/mL vs. 733 ± 124 pg/mL, <i>p</i> < 0.001; and 19.8 ± 10.6 vs. 11.3 ± 4.9, <i>p</i> < 0.001). GDF-15 level ≥920 pg/mL measured on admission had a 94% sensitivity and 91% specificity in predicting no-reflow at ROC curve analysis. In-hospital MACE was also significantly higher in group 1 (28.6% vs. 2.2%, <i>p</i>: 0.001). Additionally, there was a significant correlation between hs-CRP and GDF-15 (r: 0.6030.56; <i>p</i> < 0.001). The GDF-15 level on admission is a strong and independent predictor of poor coronary blood flow following primary PCI and in hospital MACE among patients with STEMI. Except for predictive value, GDF-15 levels may be a useful biomarker for the stratification of risk in patients with STEMI, and may carry further therapeutic implications. |
| first_indexed | 2024-03-10T19:36:29Z |
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| institution | Directory Open Access Journal |
| issn | 2079-9721 |
| language | English |
| last_indexed | 2024-03-10T19:36:29Z |
| publishDate | 2020-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diseases |
| spelling | doaj.art-464919ab48ba4c1a9d99fc612c53ae4d2023-11-20T01:39:35ZengMDPI AGDiseases2079-97212020-05-01821610.3390/diseases8020016Assessment of Growth Differentiation Factor 15 Levels on Coronary Flow in Patients with STEMI Undergoing Primary PCIOrhan Dogdu0Department of Cardiology, Medical Park Hospital, Elazig 23000, TurkeyGrowth Differentiation Factor-15 (GDF-15) is a strong predictor of decreased myocardial salvage and subsequent higher risk of death in patients with STEMI, but no information has been published regarding the association of GDF-15 levels with coronary blood flow in STEMI. We hypothesized that elevated GDF-15 levels would be associated with impaired flow and perfusion in the setting of STEMI treated with primary PCI. Eighty consecutive patients who were admitted with STEMI within 6 h from symptom onset were enrolled in the study. Patients were divided into two groups based upon the Thrombolysis in Myocardial Infarction (TIMI) flow grade. Group 1 was defined as TIMI Grade 0, 1 and 2 flows. Angiographic success was defined as TIMI 3 flow (group 2). GDF-15 and high sensitive CRP were measured. Major adverse cardiac events (MACE) were defined as stent thrombosis, nonfatal myocardial infarction and in-hospital mortality. There were 35 patients (mean age 64 ± 11.8 and 20% female) in group 1 and 45 patients (mean age 66.8 ± 11.5 and 29% female) in group 2. GDF-15 and hs-CRP levels were significantly higher in group 1 than in group 2 (1670 ± 831pg/mL vs. 733 ± 124 pg/mL, <i>p</i> < 0.001; and 19.8 ± 10.6 vs. 11.3 ± 4.9, <i>p</i> < 0.001). GDF-15 level ≥920 pg/mL measured on admission had a 94% sensitivity and 91% specificity in predicting no-reflow at ROC curve analysis. In-hospital MACE was also significantly higher in group 1 (28.6% vs. 2.2%, <i>p</i>: 0.001). Additionally, there was a significant correlation between hs-CRP and GDF-15 (r: 0.6030.56; <i>p</i> < 0.001). The GDF-15 level on admission is a strong and independent predictor of poor coronary blood flow following primary PCI and in hospital MACE among patients with STEMI. Except for predictive value, GDF-15 levels may be a useful biomarker for the stratification of risk in patients with STEMI, and may carry further therapeutic implications.https://www.mdpi.com/2079-9721/8/2/16growth differentiation factor-15ST elevation myocardial infarctionprimary percutaneous coronary intervention |
| spellingShingle | Orhan Dogdu Assessment of Growth Differentiation Factor 15 Levels on Coronary Flow in Patients with STEMI Undergoing Primary PCI Diseases growth differentiation factor-15 ST elevation myocardial infarction primary percutaneous coronary intervention |
| title | Assessment of Growth Differentiation Factor 15 Levels on Coronary Flow in Patients with STEMI Undergoing Primary PCI |
| title_full | Assessment of Growth Differentiation Factor 15 Levels on Coronary Flow in Patients with STEMI Undergoing Primary PCI |
| title_fullStr | Assessment of Growth Differentiation Factor 15 Levels on Coronary Flow in Patients with STEMI Undergoing Primary PCI |
| title_full_unstemmed | Assessment of Growth Differentiation Factor 15 Levels on Coronary Flow in Patients with STEMI Undergoing Primary PCI |
| title_short | Assessment of Growth Differentiation Factor 15 Levels on Coronary Flow in Patients with STEMI Undergoing Primary PCI |
| title_sort | assessment of growth differentiation factor 15 levels on coronary flow in patients with stemi undergoing primary pci |
| topic | growth differentiation factor-15 ST elevation myocardial infarction primary percutaneous coronary intervention |
| url | https://www.mdpi.com/2079-9721/8/2/16 |
| work_keys_str_mv | AT orhandogdu assessmentofgrowthdifferentiationfactor15levelsoncoronaryflowinpatientswithstemiundergoingprimarypci |