Circulating GDF-15 levels predict future secondary manifestations of cardiovascular disease explicitly in women but not men with atherosclerosis
| Autor: | Gerard Pasterkamp, Gert J. de Borst, Saskia Haitjema, Ian D. van Koeverden, Saskia C.A. de Jager, Harry Björkbacka, Isabel Gonçalves, Aisha Gohar, Jan Nilsson, Hester M. den Ruijter, Jean-Paul P.M. de Vries, Joyce E. P. Vrijenhoek |
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| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
Carotid Artery Diseases Male medicine.medical_specialty Pathology Growth Differentiation Factor 15 medicine.medical_treatment Renal function Disease Carotid endarterectomy 030204 cardiovascular system & hematology Cohort Studies 03 medical and health sciences 0302 clinical medicine Internal medicine Journal Article Medicine Humans Women Longitudinal Studies Risk factor Aged Medicine(all) Sex Characteristics business.industry Biomarker Middle Aged medicine.disease Atherosclerosis Prognosis 3. Good health GDF-15 030104 developmental biology Quartile Cardiovascular Diseases Cohort embryonic structures Disease Progression Secondary outcome Biomarker (medicine) Female business Cardiology and Cardiovascular Medicine Biomarkers Calcification Follow-Up Studies |
| Zdroj: | International Journal of Cardiology, 241, 430. Elsevier Ireland Ltd |
| ISSN: | 0167-5273 |
| Popis: | Background Elevated serum levels of growth differentiation factor-15 (GDF-15), is an established risk factor for a range of cardiovascular diseases. We aimed to evaluate the predictive value of plasma GDF-15 as a biomarker for secondary cardiovascular events (CVE) in patients with atherosclerosis undergoing carotid endarterectomy (CEA). Secondly, we determined whether plasma GDF-15 was associated with carotid plaque characteristics. Methods Circulating GDF-15 levels were determined by Luminex assay in a cohort of 1056 patients from the Athero-Express biobank. Composite endpoint was defined as major CVE, death and peripheral vascular interventions. Findings were validated in 473 patients from the independent Carotid Plaque Imaging Project biobank. Results GDF-15 levels did not associate with secondary CVE in the total cohort. However, following a significant interaction with sex, it was found to be strongly, independently predictive of secondary CVE in women but not men (quartile 4 vs. quartile 1: HR 3.04 [95% CI 1.35–6.86], p =0.007 in women vs. HR 0.96 [95% CI 0.66–1.40], p =0.845 in men). This was also observed in the validation cohort (women: HR 2.28 [95% CI 1.04–5.05], p =0.041), albeit dependent upon renal function. In addition, GDF-15 was associated with the presence of plaque smooth muscle cells and calcification. Conclusion High circulating GDF-15 levels are predictive of secondary CVE in women but not in men with carotid atherosclerotic disease undergoing CEA, suggesting a potential use for GDF-15 as a biomarker for secondary prevention in women. Sex differences in the role of GDF-15 in atherosclerotic disease deserve further interest. |
| Databáze: | OpenAIRE |
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