Growth differentiation factor 15 and early prognosis after out-of-hospital cardiac arrest
Abstract Background Growth differentiation factor 15 (GDF-15) is an inflammatory cytokine released in response to tissue injury. It has prognostic value in cardiovascular diseases and other acute and chronic conditions. Here, we explored the value of GDF-15 as an early predictor of neurologic outcom...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2019-10-01
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| Series: | Annals of Intensive Care |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13613-019-0593-9 |
| _version_ | 1819016405141422080 |
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| author | Ferran Rueda Germán Cediel Cosme García-García Júlia Aranyó Marta González-Lopera M. Cruz Aranda Nevado Judith Serra Gregori Teresa Oliveras Carlos Labata Marc Ferrer Nabil El Ouaddi Antoni Bayés-Genís |
| author_facet | Ferran Rueda Germán Cediel Cosme García-García Júlia Aranyó Marta González-Lopera M. Cruz Aranda Nevado Judith Serra Gregori Teresa Oliveras Carlos Labata Marc Ferrer Nabil El Ouaddi Antoni Bayés-Genís |
| author_sort | Ferran Rueda |
| collection | DOAJ |
| description | Abstract Background Growth differentiation factor 15 (GDF-15) is an inflammatory cytokine released in response to tissue injury. It has prognostic value in cardiovascular diseases and other acute and chronic conditions. Here, we explored the value of GDF-15 as an early predictor of neurologic outcome after an out-of-hospital cardiac arrest (OHCA). Methods Prospective registry study of patients in coma after an OHCA, admitted in the intensive cardiac care unit from a single university center. Serum levels of GDF-15 were measured on admission. Neurologic status was evaluated according to the cerebral performance category (CPC) scale. The relationship between GDF-15 levels and poor neurologic outcome at 6 months was analyzed. Results Among 62 patients included, 32 (51.6%) presented poor outcome (CPC 3–5). Patients with CPC 3–5 exhibited significantly higher GDF-15 levels (median, 17.1 [IQR, 11.1–20.4] ng/mL) compared to those with CPC 1–2 (7.6 [IQR, 4.1–13.1] ng/mL; p = 0.004). Multivariable logistic regression analyses showed that age (OR, 1.09; 95% CI 1.01–1.17; p = 0.020), home setting arrest (OR, 8.07; 95% CI 1.61–40.42; p = 0.011), no bystander cardiopulmonary resuscitation (OR, 7.91; 95% CI 1.84–34.01; p = 0.005), and GDF-15 levels (OR, 3.74; 95% CI 1.32–10.60; p = 0.013) were independent predictors of poor outcome. The addition of GDF-15 in a dichotomous manner (≥ 10.8 vs. < 10.8 ng/mL) to the resulting clinical model improved discrimination; it increased the area under the curve from 0.867 to 0.917, and the associated continuous net reclassification improvement was 0.90 (95% CI 0.48–1.44), which allowed reclassification of 37.1% of patients. Conclusions After an OHCA, increased GDF-15 levels were an independent, early predictor of poor neurologic outcome. Furthermore, when added to the most common clinical factors, GDF-15 improved discrimination and allowed patient reclassification. |
| first_indexed | 2024-12-21T02:47:06Z |
| format | Article |
| id | doaj.art-8eee3dfd8cdd4ff79f93b0d77a2ef75d |
| institution | Directory Open Access Journal |
| issn | 2110-5820 |
| language | English |
| last_indexed | 2024-12-21T02:47:06Z |
| publishDate | 2019-10-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Annals of Intensive Care |
| spelling | doaj.art-8eee3dfd8cdd4ff79f93b0d77a2ef75d2022-12-21T19:18:32ZengSpringerOpenAnnals of Intensive Care2110-58202019-10-019111010.1186/s13613-019-0593-9Growth differentiation factor 15 and early prognosis after out-of-hospital cardiac arrestFerran Rueda0Germán Cediel1Cosme García-García2Júlia Aranyó3Marta González-Lopera4M. Cruz Aranda Nevado5Judith Serra Gregori6Teresa Oliveras7Carlos Labata8Marc Ferrer9Nabil El Ouaddi10Antoni Bayés-Genís11Heart Institute, Germans Trias i Pujol University HospitalHeart Institute, Germans Trias i Pujol University HospitalHeart Institute, Germans Trias i Pujol University HospitalHeart Institute, Germans Trias i Pujol University HospitalHeart Institute, Germans Trias i Pujol University HospitalHeart Institute, Germans Trias i Pujol University HospitalHeart Institute, Germans Trias i Pujol University HospitalHeart Institute, Germans Trias i Pujol University HospitalHeart Institute, Germans Trias i Pujol University HospitalHeart Institute, Germans Trias i Pujol University HospitalHeart Institute, Germans Trias i Pujol University HospitalHeart Institute, Germans Trias i Pujol University HospitalAbstract Background Growth differentiation factor 15 (GDF-15) is an inflammatory cytokine released in response to tissue injury. It has prognostic value in cardiovascular diseases and other acute and chronic conditions. Here, we explored the value of GDF-15 as an early predictor of neurologic outcome after an out-of-hospital cardiac arrest (OHCA). Methods Prospective registry study of patients in coma after an OHCA, admitted in the intensive cardiac care unit from a single university center. Serum levels of GDF-15 were measured on admission. Neurologic status was evaluated according to the cerebral performance category (CPC) scale. The relationship between GDF-15 levels and poor neurologic outcome at 6 months was analyzed. Results Among 62 patients included, 32 (51.6%) presented poor outcome (CPC 3–5). Patients with CPC 3–5 exhibited significantly higher GDF-15 levels (median, 17.1 [IQR, 11.1–20.4] ng/mL) compared to those with CPC 1–2 (7.6 [IQR, 4.1–13.1] ng/mL; p = 0.004). Multivariable logistic regression analyses showed that age (OR, 1.09; 95% CI 1.01–1.17; p = 0.020), home setting arrest (OR, 8.07; 95% CI 1.61–40.42; p = 0.011), no bystander cardiopulmonary resuscitation (OR, 7.91; 95% CI 1.84–34.01; p = 0.005), and GDF-15 levels (OR, 3.74; 95% CI 1.32–10.60; p = 0.013) were independent predictors of poor outcome. The addition of GDF-15 in a dichotomous manner (≥ 10.8 vs. < 10.8 ng/mL) to the resulting clinical model improved discrimination; it increased the area under the curve from 0.867 to 0.917, and the associated continuous net reclassification improvement was 0.90 (95% CI 0.48–1.44), which allowed reclassification of 37.1% of patients. Conclusions After an OHCA, increased GDF-15 levels were an independent, early predictor of poor neurologic outcome. Furthermore, when added to the most common clinical factors, GDF-15 improved discrimination and allowed patient reclassification.http://link.springer.com/article/10.1186/s13613-019-0593-9Out-of-hospital cardiac arrestPrognosticationNeurologic outcomeGrowth differentiation factor 15Biomarkers |
| spellingShingle | Ferran Rueda Germán Cediel Cosme García-García Júlia Aranyó Marta González-Lopera M. Cruz Aranda Nevado Judith Serra Gregori Teresa Oliveras Carlos Labata Marc Ferrer Nabil El Ouaddi Antoni Bayés-Genís Growth differentiation factor 15 and early prognosis after out-of-hospital cardiac arrest Annals of Intensive Care Out-of-hospital cardiac arrest Prognostication Neurologic outcome Growth differentiation factor 15 Biomarkers |
| title | Growth differentiation factor 15 and early prognosis after out-of-hospital cardiac arrest |
| title_full | Growth differentiation factor 15 and early prognosis after out-of-hospital cardiac arrest |
| title_fullStr | Growth differentiation factor 15 and early prognosis after out-of-hospital cardiac arrest |
| title_full_unstemmed | Growth differentiation factor 15 and early prognosis after out-of-hospital cardiac arrest |
| title_short | Growth differentiation factor 15 and early prognosis after out-of-hospital cardiac arrest |
| title_sort | growth differentiation factor 15 and early prognosis after out of hospital cardiac arrest |
| topic | Out-of-hospital cardiac arrest Prognostication Neurologic outcome Growth differentiation factor 15 Biomarkers |
| url | http://link.springer.com/article/10.1186/s13613-019-0593-9 |
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