Combination Of GDF-15 And NT-proBNP To Predict Long-term Mortality In Patients With Acute Heart Failure

Objective : 1,significance in differe to test the plasma level of GDF-15 and NT-pro BNP,and investigate the statistical nt groups in patients with acute heart failure,2,To evaluate the clinic value of GDF-15 in predicting 1-year all-cause mortality in patients with acute heart failure,3,To compare the clinic value of GDF-15 and NT-pro BNP in predicting 1-year all-cause mortality in patients with acute heart failure.Methods:260 patients with acute heart failure were enrolled in Jiangsu Provincial People’s hospital from April 2012 to May 2016.Questionnaire was designed according to the trial,Based on clinical symptom and signs,record their general information,medical history and so on,All subjects underwent physical examination,anthropometric measurements,echocardiography examination and biochemical screening.Plasma level of GDF-15 and NT-pro BNP were determined by ELISA.To analysis the data by SPSS 23.0 statistical software.Results:1,Plasma level of GDF-15 and NT-pro BNP was higher in group of survivors than that in the group of death(P<0.001),2,The AUC for GDF-15 as a predicator of 1-year mortality was 0.707(P < 0.0001),which was similar to that for NT-pro BNP(AUC = 0.682,P = 0.65).The combination of GDF-15 and NT-pro BNP values(AUC = 0.743,P < 0.0001)was better than the two parameters separately(P = 0.241 for comparison to GDF-15,P = 0.059 for comparison to NT-pro BNP).3,The optimal cut-off point for GDF-15 was 4526.0 ng/L,with 57% sensitivity(95%CI: 41%-71%)and 80% specificity(95%CI: 74%-86%).The best cutoff point for NT-pro BNP was 1978.0 ng/L and had 76% sensitivity(95%CI: 61%-84%)and 52% specificity(95%CI: 45% to 59%).4,The group of patients with high GDF-15 or NT-pro BNP values was at high risk of death.(long-rank test,P < 0.001),The mortality(38.2%)in the group with GDF-15 greater than 4526.0 ng/L was over 3-fold higher compared to the opposite group(10.4%,P < 0.001).The difference between the NT-pro BNP groups was almost similar(25.5% for > 1978.0 ng/L versus 8.9% for ≤ 1978.0 ng/L,P < 0.001).5,Multivariable logistic regression model using the Forward Stepwise method to determine predictors independently related to 1-year mortality.The clinic value was higher in predicting 1-year all-cause mortality in patients with acute heart failure when both GDF-15 and NT-pro BNP rised.Conclusion:1,Plasma level of GDF-15 and NT-pro BNP was useful to Predict 1-year mortality in patients with acute heart failure,2,GDF-15 and NT-pro BNP were independently related to 1-year mortality in patients with acute heart failure,The clinic value was higher in predicting 1-year all-cause mortality when both GDF-15 and NT-pro BNP rised.