Limited incremental value of growth differentiation factor 15 in the initial evaluation of low and intermediate risk acute chest pain patients

IF 2.5 3区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Clinical biochemistry Pub Date : 2025-04-04 DOI:10.1016/j.clinbiochem.2025.110926

Iman Karaji , Ole-Thomas Steiro , Gard MS Myrmel , Torbjørn Omland , Hilde L Tjora , Jørund Langørgen , Rune Bjørneklett , Øyvind Skadberg , Vernon VS Bonarjee , Øistein R Mjelva , Paul Collinson , Kjell Vikenes , Terje H Larsen , Kristin M Aakre , Eva Ringdal Pedersen

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引用次数: 0

Abstract

Introduction

Expression of the cytokine growth differentiation factor 15 (GDF-15) is up-regulated in conditions of tissue injury and stress. We evaluated if GDF-15 predicts obstructive coronary artery disease (CAD) or need for revascularization within 30 days and 12 months in low/intermediate risk patients with acute chest pain.

Materials and Methods

We included 537 hospitalized patients who had high-sensitivity troponin T (hs-cTnT) < 99th percentile and underwent coronary CT angiography (CCTA). Odds ratios (ORs) and 95 % confidence intervals (CI) were calculated by logistic regression analyses and are reported per standard deviation increment of GDF-15 (log-transformed).

Results

The median (25th-75th percentile) age was 56 (49–65) years, 217 (40.4 %) were women, 83 (15.5 %) had obstructive CAD at CCTA. In total 49 (9.1 %) patients underwent revascularization within 30 days and 52 (9.7 %) within 12 months. In age and sex adjusted analysis GDF-15 was a significant predictor with ORs (95 % CI) of 1.35 (1.05–1.73), 1.39 (1.06–1.83) and 1.41 (1.07–1.84) for obstructive CAD, revascularization within 30 days and 12 months, respectively. However, after adjustment for clinical covariables, the ORs of GDF-15 were no longer statistically significant for either outcome (P ≥ 0.07). Adding hs-cTnT levels alone to the age and sex adjusted model also rendered the ORs of GDF-15 non-significant (P ≥ 0.31).

Conclusions

In patients with acute chest pain but without acute myocardial infarction, GDF-15 did not substantially improve the identification of obstructive CAD or need for revascularization within 30 days and 12 months. Our findings question the clinical usefulness of GDF-15 for prognostication of low-risk patients with acute chest pain.

查看原文本刊更多论文

生长分化因子15在低、中危急性胸痛患者初始评价中的增量价值有限。

简介细胞因子生长分化因子 15 (GDF-15) 的表达在组织损伤和应激状态下会上调。我们评估了 GDF-15 是否能预测急性胸痛低/中危患者 30 天和 12 个月内的阻塞性冠状动脉疾病（CAD）或血管重建需求：我们纳入了 537 名有高敏肌钙蛋白 T（hs-cTnT）的住院患者：中位数（第 25-75 百分位数）年龄为 56（49-65）岁，217（40.4%）人为女性，83（15.5%）人在接受 CCTA 检查时患有阻塞性 CAD。共有 49 名患者（9.1%）在 30 天内接受了血管重建手术，52 名患者（9.7%）在 12 个月内接受了血管重建手术。在年龄和性别调整分析中，GDF-15 是一个重要的预测因子，阻塞性 CAD、30 天内血管再通和 12 个月内血管再通的 ORs (95 % CI) 分别为 1.35 (1.05-1.73)、1.39 (1.06-1.83) 和 1.41 (1.07-1.84)。然而，在对临床协变量进行调整后，GDF-15 对这两种结果的 ORs 不再具有统计学意义（P ≥ 0.07）。将 hs-cTnT 水平单独加入年龄和性别调整模型后，GDF-15 的 ORs 也不显著（P≥ 0.31）：对于急性胸痛但未发生急性心肌梗死的患者，GDF-15 并未显著提高阻塞性 CAD 的识别率或在 30 天和 12 个月内进行血管重建的必要性。我们的研究结果质疑了 GDF-15 对低风险急性胸痛患者预后的临床实用性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical biochemistry 医学-医学实验技术

CiteScore

5.10

自引率

0.00%

发文量

151

审稿时长

25 days

期刊介绍： Clinical Biochemistry publishes articles relating to clinical chemistry, molecular biology and genetics, therapeutic drug monitoring and toxicology, laboratory immunology and laboratory medicine in general, with the focus on analytical and clinical investigation of laboratory tests in humans used for diagnosis, prognosis, treatment and therapy, and monitoring of disease.