Growth-differentiation factor 15 for long-term prognostication in patients with non-ST-elevation acute coronary syndrome: an Invasive versus Conservative Treatment in Unstable coronary Syndromes (ICTUS) substudy

Peter Damman; Tibor Kempf; ICTUS investigators; Fons Windhausen; Jan P van Straalen; Anja Guba-Quint; Johan Fischer; Jan G P Tijssen; Kai C Wollert; Robbert J de Winter; Alexander Hirsch

doi:10.1016/j.ijcard.2014.01.025

Growth-differentiation factor 15 for long-term prognostication in patients with non-ST-elevation acute coronary syndrome: an Invasive versus Conservative Treatment in Unstable coronary Syndromes (ICTUS) substudy

Peter Damman, Tibor Kempf, ICTUS investigators, Fons Windhausen, Jan P van Straalen, Anja Guba-Quint, Johan Fischer, Jan G P Tijssen, Kai C Wollert, Robbert J de Winter, Alexander Hirsch

Research output: Contribution to journal › Article › Academic › peer-review

35 Citations (Scopus)

Abstract

BACKGROUND: No five-year long-term follow-up data is available regarding the prognostic value of GDF-15. Our aim is to evaluate the long-term prognostic value of admission growth-differentiation factor 15 (GDF-15) regarding death or myocardial infarction (MI) in patients with non-ST-elevation acute coronary syndrome (NSTE-ACS).

METHODS: This is a subanalysis from the ICTUS (Invasive versus Conservative Treatment in Unstable coronary Syndromes) trial, including troponin positive NSTE-ACS patients. The main outcome for the current analysis was 5-year death or spontaneous MI. GDF-15 samples were available in 1151 patients. The prognostic value of GDF-15, categorized into <1200 ng/L, 1200-1800 ng/L and >1800 ng/L, was assessed in unadjusted and adjusted Cox regression models. Adjustments were made for identified univariable risk factors. The additional discriminative and reclassification value of GDF-15 beyond the independent risk factors was assessed by the category-free net reclassification improvement (1/2 NRI(>0)) and the integrated discrimination improvement (IDI) RESULTS: Compared to GDF-15<1200 ng/L, a GDF-15>1800 ng/L was associated with an increased hazard ratio for death or spontaneous MI, mainly driven by mortality. GDF-15 levels were predictive after adjustments for other identified predictors. Additional discriminative value was shown with the IDI, not with the NRI.

CONCLUSION: In patients presenting with NSTE-ACS and elevated troponin T, GDF-15 provides prognostic information in addition to identified predictors for mortality and spontaneous MI and can be used to identify patients at high risk during long-term follow-up.

Original language	English
Pages (from-to)	356-63
Number of pages	8
Journal	International Journal of Cardiology
Volume	172
Issue number	2
DOIs	https://doi.org/10.1016/j.ijcard.2014.01.025
Publication status	Published - 15 Mar 2014
Externally published	Yes

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Damman, P., Kempf, T., ICTUS investigators, Windhausen, F., van Straalen, J. P., Guba-Quint, A., Fischer, J., Tijssen, J. G. P., Wollert, K. C., de Winter, R. J., & Hirsch, A. (2014). Growth-differentiation factor 15 for long-term prognostication in patients with non-ST-elevation acute coronary syndrome: an Invasive versus Conservative Treatment in Unstable coronary Syndromes (ICTUS) substudy. International Journal of Cardiology, 172(2), 356-63. https://doi.org/10.1016/j.ijcard.2014.01.025

@article{72088323013a417fbd61e8167df85cdc,

title = "Growth-differentiation factor 15 for long-term prognostication in patients with non-ST-elevation acute coronary syndrome: an Invasive versus Conservative Treatment in Unstable coronary Syndromes (ICTUS) substudy",

abstract = "BACKGROUND: No five-year long-term follow-up data is available regarding the prognostic value of GDF-15. Our aim is to evaluate the long-term prognostic value of admission growth-differentiation factor 15 (GDF-15) regarding death or myocardial infarction (MI) in patients with non-ST-elevation acute coronary syndrome (NSTE-ACS).METHODS: This is a subanalysis from the ICTUS (Invasive versus Conservative Treatment in Unstable coronary Syndromes) trial, including troponin positive NSTE-ACS patients. The main outcome for the current analysis was 5-year death or spontaneous MI. GDF-15 samples were available in 1151 patients. The prognostic value of GDF-15, categorized into <1200 ng/L, 1200-1800 ng/L and >1800 ng/L, was assessed in unadjusted and adjusted Cox regression models. Adjustments were made for identified univariable risk factors. The additional discriminative and reclassification value of GDF-15 beyond the independent risk factors was assessed by the category-free net reclassification improvement (1/2 NRI(>0)) and the integrated discrimination improvement (IDI) RESULTS: Compared to GDF-15<1200 ng/L, a GDF-15>1800 ng/L was associated with an increased hazard ratio for death or spontaneous MI, mainly driven by mortality. GDF-15 levels were predictive after adjustments for other identified predictors. Additional discriminative value was shown with the IDI, not with the NRI.CONCLUSION: In patients presenting with NSTE-ACS and elevated troponin T, GDF-15 provides prognostic information in addition to identified predictors for mortality and spontaneous MI and can be used to identify patients at high risk during long-term follow-up.",

author = "Peter Damman and Tibor Kempf and \{ICTUS investigators\} and Fons Windhausen and \{van Straalen\}, \{Jan P\} and Anja Guba-Quint and Johan Fischer and Tijssen, \{Jan G P\} and Wollert, \{Kai C\} and \{de Winter\}, \{Robbert J\} and Alexander Hirsch",

year = "2014",

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day = "15",

doi = "10.1016/j.ijcard.2014.01.025",

language = "English",

volume = "172",

pages = "356--63",

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Damman, P, Kempf, T, ICTUS investigators, Windhausen, F, van Straalen, JP, Guba-Quint, A, Fischer, J, Tijssen, JGP, Wollert, KC, de Winter, RJ & Hirsch, A 2014, 'Growth-differentiation factor 15 for long-term prognostication in patients with non-ST-elevation acute coronary syndrome: an Invasive versus Conservative Treatment in Unstable coronary Syndromes (ICTUS) substudy', International Journal of Cardiology, vol. 172, no. 2, pp. 356-63. https://doi.org/10.1016/j.ijcard.2014.01.025

Growth-differentiation factor 15 for long-term prognostication in patients with non-ST-elevation acute coronary syndrome: an Invasive versus Conservative Treatment in Unstable coronary Syndromes (ICTUS) substudy. / Damman, Peter; Kempf, Tibor; ICTUS investigators et al.
In: International Journal of Cardiology, Vol. 172, No. 2, 15.03.2014, p. 356-63.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Growth-differentiation factor 15 for long-term prognostication in patients with non-ST-elevation acute coronary syndrome

T2 - an Invasive versus Conservative Treatment in Unstable coronary Syndromes (ICTUS) substudy

AU - Damman, Peter

AU - Kempf, Tibor

AU - ICTUS investigators

AU - Windhausen, Fons

AU - van Straalen, Jan P

AU - Guba-Quint, Anja

AU - Fischer, Johan

AU - Tijssen, Jan G P

AU - Wollert, Kai C

AU - de Winter, Robbert J

AU - Hirsch, Alexander

PY - 2014/3/15

Y1 - 2014/3/15

N2 - BACKGROUND: No five-year long-term follow-up data is available regarding the prognostic value of GDF-15. Our aim is to evaluate the long-term prognostic value of admission growth-differentiation factor 15 (GDF-15) regarding death or myocardial infarction (MI) in patients with non-ST-elevation acute coronary syndrome (NSTE-ACS).METHODS: This is a subanalysis from the ICTUS (Invasive versus Conservative Treatment in Unstable coronary Syndromes) trial, including troponin positive NSTE-ACS patients. The main outcome for the current analysis was 5-year death or spontaneous MI. GDF-15 samples were available in 1151 patients. The prognostic value of GDF-15, categorized into <1200 ng/L, 1200-1800 ng/L and >1800 ng/L, was assessed in unadjusted and adjusted Cox regression models. Adjustments were made for identified univariable risk factors. The additional discriminative and reclassification value of GDF-15 beyond the independent risk factors was assessed by the category-free net reclassification improvement (1/2 NRI(>0)) and the integrated discrimination improvement (IDI) RESULTS: Compared to GDF-15<1200 ng/L, a GDF-15>1800 ng/L was associated with an increased hazard ratio for death or spontaneous MI, mainly driven by mortality. GDF-15 levels were predictive after adjustments for other identified predictors. Additional discriminative value was shown with the IDI, not with the NRI.CONCLUSION: In patients presenting with NSTE-ACS and elevated troponin T, GDF-15 provides prognostic information in addition to identified predictors for mortality and spontaneous MI and can be used to identify patients at high risk during long-term follow-up.

AB - BACKGROUND: No five-year long-term follow-up data is available regarding the prognostic value of GDF-15. Our aim is to evaluate the long-term prognostic value of admission growth-differentiation factor 15 (GDF-15) regarding death or myocardial infarction (MI) in patients with non-ST-elevation acute coronary syndrome (NSTE-ACS).METHODS: This is a subanalysis from the ICTUS (Invasive versus Conservative Treatment in Unstable coronary Syndromes) trial, including troponin positive NSTE-ACS patients. The main outcome for the current analysis was 5-year death or spontaneous MI. GDF-15 samples were available in 1151 patients. The prognostic value of GDF-15, categorized into <1200 ng/L, 1200-1800 ng/L and >1800 ng/L, was assessed in unadjusted and adjusted Cox regression models. Adjustments were made for identified univariable risk factors. The additional discriminative and reclassification value of GDF-15 beyond the independent risk factors was assessed by the category-free net reclassification improvement (1/2 NRI(>0)) and the integrated discrimination improvement (IDI) RESULTS: Compared to GDF-15<1200 ng/L, a GDF-15>1800 ng/L was associated with an increased hazard ratio for death or spontaneous MI, mainly driven by mortality. GDF-15 levels were predictive after adjustments for other identified predictors. Additional discriminative value was shown with the IDI, not with the NRI.CONCLUSION: In patients presenting with NSTE-ACS and elevated troponin T, GDF-15 provides prognostic information in addition to identified predictors for mortality and spontaneous MI and can be used to identify patients at high risk during long-term follow-up.

U2 - 10.1016/j.ijcard.2014.01.025

DO - 10.1016/j.ijcard.2014.01.025

M3 - Article

C2 - 24502880

SN - 0167-5273

VL - 172

SP - 356

EP - 363

JO - International Journal of Cardiology

JF - International Journal of Cardiology

IS - 2

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Damman P, Kempf T, ICTUS investigators, Windhausen F, van Straalen JP, Guba-Quint A et al. Growth-differentiation factor 15 for long-term prognostication in patients with non-ST-elevation acute coronary syndrome: an Invasive versus Conservative Treatment in Unstable coronary Syndromes (ICTUS) substudy. International Journal of Cardiology. 2014 Mar 15;172(2):356-63. doi: 10.1016/j.ijcard.2014.01.025