Growth Differentiation Factor‐15 Predicts Death and Stroke Event in Outpatients With Cardiovascular Risk Factors: The J‐HOP Study
Background Growth differentiation factor‐15 (GDF‐15) has emerged as a novel biomarker to predict all‐cause death in community‐dwelling individuals and patients with cardiovascular disease. We evaluated the prognostic value of GDF‐15 in outpatients with cardiovascular risk factors. Methods and Result...
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| Format: | Article |
| Language: | English |
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Wiley
2021-12-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.121.022601 |
| _version_ | 1797945415626129408 |
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| author | Keita Negishi Satoshi Hoshide Masahisa Shimpo Hiroshi Kanegae Kazuomi Kario |
| author_facet | Keita Negishi Satoshi Hoshide Masahisa Shimpo Hiroshi Kanegae Kazuomi Kario |
| author_sort | Keita Negishi |
| collection | DOAJ |
| description | Background Growth differentiation factor‐15 (GDF‐15) has emerged as a novel biomarker to predict all‐cause death in community‐dwelling individuals and patients with cardiovascular disease. We evaluated the prognostic value of GDF‐15 in outpatients with cardiovascular risk factors. Methods and Results GDF‐15 levels were measured in 3562 outpatients with cardiovascular risk factors in the J‐HOP (Japan Morning Surge‐Home Blood Pressure) study, a nationwide prospective study. Participants were stratified according to tertiles of GDF‐15 and followed up for all‐cause death and cardiovascular disease. During a mean follow‐up period of 6.6 years, there were 155 all‐cause deaths, 81 stroke events including cerebral infarction and intracranial hemorrhage, and 141 cardiac events including cardiac artery disease and heart failure. Patients with higher GDF‐15 levels were associated with risks of all‐cause death and stroke events (except for cardiac events) after adjustment for traditional risk factors and other prognostic biomarkers (NT‐proBNP [N‐terminal pro‐B‐type natriuretic peptide], high‐sensitivity troponin T; all‐cause death, hazard ratio, 2.38; 95% CI, 1.26–4.48; P=0.007; stroke events, hazard ratio, 2.93; 95% CI, 1.31–6.56, P=0.009; compared with the lowest tertile). Furthermore, incorporating GDF‐15 to the predictive models for all‐cause death improved discrimination and reclassification significantly. For stroke events, GDF‐15 showed similar diagnostic accuracy to NT‐proBNP and high‐sensitivity troponin T. Conclusions In Japanese outpatients with cardiovascular risk factors, GDF‐15 improves risk stratification for all‐cause death when compared with NT‐proBNP and high‐sensitivity troponin T. GDF‐15 was associated with increased risks of stroke events beyond conventional risk factors and other prognostic markers; however, the predictive ability for stroke events was equivalent to NT‐proBNP and high‐sensitivity troponin T. Registration URL: http://www.umin.ac.jp/ctr.; Unique identifier: UMIN000000894. |
| first_indexed | 2024-04-10T20:54:47Z |
| format | Article |
| id | doaj.art-97f82ded54be4aec9efea21244304af4 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-10T20:54:47Z |
| publishDate | 2021-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-97f82ded54be4aec9efea21244304af42023-01-23T07:23:59ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802021-12-01102410.1161/JAHA.121.022601Growth Differentiation Factor‐15 Predicts Death and Stroke Event in Outpatients With Cardiovascular Risk Factors: The J‐HOP StudyKeita Negishi0Satoshi Hoshide1Masahisa Shimpo2Hiroshi Kanegae3Kazuomi Kario4Division of Cardiovascular Medicine Department of Medicine Jichi Medical University Tochigi JapanDivision of Cardiovascular Medicine Department of Medicine Jichi Medical University Tochigi JapanDivision of Cardiovascular Medicine Department of Medicine Jichi Medical University Tochigi JapanDivision of Cardiovascular Medicine Department of Medicine Jichi Medical University Tochigi JapanDivision of Cardiovascular Medicine Department of Medicine Jichi Medical University Tochigi JapanBackground Growth differentiation factor‐15 (GDF‐15) has emerged as a novel biomarker to predict all‐cause death in community‐dwelling individuals and patients with cardiovascular disease. We evaluated the prognostic value of GDF‐15 in outpatients with cardiovascular risk factors. Methods and Results GDF‐15 levels were measured in 3562 outpatients with cardiovascular risk factors in the J‐HOP (Japan Morning Surge‐Home Blood Pressure) study, a nationwide prospective study. Participants were stratified according to tertiles of GDF‐15 and followed up for all‐cause death and cardiovascular disease. During a mean follow‐up period of 6.6 years, there were 155 all‐cause deaths, 81 stroke events including cerebral infarction and intracranial hemorrhage, and 141 cardiac events including cardiac artery disease and heart failure. Patients with higher GDF‐15 levels were associated with risks of all‐cause death and stroke events (except for cardiac events) after adjustment for traditional risk factors and other prognostic biomarkers (NT‐proBNP [N‐terminal pro‐B‐type natriuretic peptide], high‐sensitivity troponin T; all‐cause death, hazard ratio, 2.38; 95% CI, 1.26–4.48; P=0.007; stroke events, hazard ratio, 2.93; 95% CI, 1.31–6.56, P=0.009; compared with the lowest tertile). Furthermore, incorporating GDF‐15 to the predictive models for all‐cause death improved discrimination and reclassification significantly. For stroke events, GDF‐15 showed similar diagnostic accuracy to NT‐proBNP and high‐sensitivity troponin T. Conclusions In Japanese outpatients with cardiovascular risk factors, GDF‐15 improves risk stratification for all‐cause death when compared with NT‐proBNP and high‐sensitivity troponin T. GDF‐15 was associated with increased risks of stroke events beyond conventional risk factors and other prognostic markers; however, the predictive ability for stroke events was equivalent to NT‐proBNP and high‐sensitivity troponin T. Registration URL: http://www.umin.ac.jp/ctr.; Unique identifier: UMIN000000894.https://www.ahajournals.org/doi/10.1161/JAHA.121.022601cardiovascular diseaseGDF‐15hypertensionmortalitystroke |
| spellingShingle | Keita Negishi Satoshi Hoshide Masahisa Shimpo Hiroshi Kanegae Kazuomi Kario Growth Differentiation Factor‐15 Predicts Death and Stroke Event in Outpatients With Cardiovascular Risk Factors: The J‐HOP Study Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease cardiovascular disease GDF‐15 hypertension mortality stroke |
| title | Growth Differentiation Factor‐15 Predicts Death and Stroke Event in Outpatients With Cardiovascular Risk Factors: The J‐HOP Study |
| title_full | Growth Differentiation Factor‐15 Predicts Death and Stroke Event in Outpatients With Cardiovascular Risk Factors: The J‐HOP Study |
| title_fullStr | Growth Differentiation Factor‐15 Predicts Death and Stroke Event in Outpatients With Cardiovascular Risk Factors: The J‐HOP Study |
| title_full_unstemmed | Growth Differentiation Factor‐15 Predicts Death and Stroke Event in Outpatients With Cardiovascular Risk Factors: The J‐HOP Study |
| title_short | Growth Differentiation Factor‐15 Predicts Death and Stroke Event in Outpatients With Cardiovascular Risk Factors: The J‐HOP Study |
| title_sort | growth differentiation factor 15 predicts death and stroke event in outpatients with cardiovascular risk factors the j hop study |
| topic | cardiovascular disease GDF‐15 hypertension mortality stroke |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.121.022601 |
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