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Towards a multi-marker prognostic strategy in acute heart failure: a role for GDF-15

2018Journal article Open access
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dc.contributor.authorBettencourt, Paulo
dc.contributor.authorFerreira-Coimbra, João
dc.contributor.authorRodrigues, Pedro
dc.contributor.authorMarques, Pedro
dc.contributor.authorMoreira, Helena
dc.contributor.authorPinto, Maria João
dc.contributor.authorGuimarães, João Tiago
dc.contributor.authorLourenço, Patrícia
dc.date.accessioned2019-02-12T13:19:34Z
dc.date.available2019-02-12T13:19:34Z
dc.date.issued2018
dc.description.abstractAIMS: Growth differentiation factor (GDF)-15 mirrors inflammation and oxidative stress in cardiovascular diseases. Brain natriuretic peptide (BNP) is associated with cardiomyocyte stretch in heart failure (HF). The objective of this study was to evaluate the prognostic impact of plasma GDF-15 and BNP in acute HF. METHODS AND RESULTS: We studied a subgroup of patients prospectively recruited in an acute HF registry (follow-up: 2 years; endpoint: all-cause mortality). Cox regression multivariate models were built to study the association of GDF-15 and mortality. Further cross-classification according to discharge GDF-15 (mean) and BNP (mean) and association with mortality was studied. We studied 158 patients: seventy-nine were male, mean age was 75 years, 55.1% had left ventricular ejection fraction < 40%, mean discharge BNP was 1000 pg/mL, and mean GDF-15 was 3013 ng/mL. Higher BNP and GDF-15 predicted 2-year mortality. Patients with GDF-15 ≥ 3000 ng/mL had a multivariate adjusted 2-year death risk of 1.86 (1.08-3.18). Patients discharged with both BNP and GDF-15 above the mean had an adjusted hazard ratio of 4.33 (2.07-9.06) when compared with those with both <mean. CONCLUSIONS: Higher GDF-15 associated with worse prognosis in acute HF independently of BNP. When both biomarkers GDF-15 and BNP were elevated at discharge, the 2-year mortality risk increased over four-fold. Biomarkers related to different pathophysiological pathways can provide incremental prognostic information in acute HF.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationBettencourt P, Ferreira-Coimbra J, Rodrigues P, Marques P, Moreira H, Pinto MJ, Guimarães JT, Lourenço P. ESC Heart Fail. 2018 Dec;5(6):1017-1022.pt_PT
dc.identifier.doidoi: 10.1002/ehf2.12301pt_PT
dc.identifier.issn2055-5822
dc.identifier.urihttp://hdl.handle.net/10400.26/27792
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherJohn Wiley and Sonspt_PT
dc.relation.publisherversionhttps://www.wiley.com/pt_PT
dc.rights.urihttp://creativecommons.org/licenses/by-nd/4.0/pt_PT
dc.subjectGDF-15pt_PT
dc.subjectHeart failurept_PT
dc.subjectMortalitypt_PT
dc.subjectNatriuretic peptidespt_PT
dc.subjectPrognosispt_PT
dc.titleTowards a multi-marker prognostic strategy in acute heart failure: a role for GDF-15pt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage1022pt_PT
oaire.citation.issue5pt_PT
oaire.citation.startPage1077pt_PT
oaire.citation.titleESC Heart Failurept_PT
oaire.citation.volume6pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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