Clinical Value Of Plasma Growth Differentiation Factor-15 In Patients With Coronary Heart Disease

ObjectiveTo determine the plasma growth differentiation factor-15（GDF-15）level in patients with coronary heart disease,and to analyze the correlation between GDF-15 and coronary coronary heart disease severity.And then to compare the plasma levels of GDF-15 between acute myocardial infarction patients with heart failure and those who without heart failure.Further study the diagnostic value of GDF-15 level in patients with heart failure after acute myocardial infarction.MethodsIn this study,141 patients with coronary heart disease who met the criteria were selected from November 2019 to May 2020 to Tai Zhou People’s Hospital.All the patients were divided into two groups:one group had 42 patients with stable angina pectoris and 99 patients with acute coronary syndrome in the other.Patients with acute myocardial infarction then were subdivided into subgroups according to the occurrence of heart failure.In addition,44 healthy persons who went to the physical examination center of Tai Zhou People’s Hospital during this period were selected.Record the relevant information of the people in the study in detail,such as gender,age,BMI,smoking and drinking history,past medical history,blood pressure at admission,clinical diagnosis,hospitalization time,medications ordered by doctor,etc.To collect the relevant laboratory examination results during hospitalization,such as routine blood test,blood biochemistry test,lipid profile,glycosylated hemoglobin,Creatine kinase isoenzyme-MB,c Tn I,NT-pro BNP,etc.To collect the results of imaging echocardiography,dual source coronary CT angiography（CCTA）and coronary angiogram in patients with coronary heart disease.The peripheral venous blood 2ml of all people in the study was collected and centrifuged.The plasma from blood was collected into the frozen tube and stored in the refrigerator at-80℃.After all the samples have been collected,the ELISA kit was used to determine the level of plasma GDF-15.Statistical analysis data,Nonparametric test was used to compare the differences of GDF-15levels among three groups of patients with different levels of coronary coronary heart disease severity,T-test was used to compare the difference of plasma GDF-15 levels between patients without heart failure after acute myocardial infarction and patients with heart failure after acute myocardial infarction,Logistic regression analysis was used to determine whether GDF-15 was an independent predictor of heart failure after acute myocardial infarction,and to evaluate the diagnostic value of GDF-15 and NT-pro BNP in heart failure after acute myocardial infarction by analyzing ROC curve.Results1.The level of plasma GDF-15 in healthy control group,stable angina pectoris group and acute coronary syndrome group increased successively（p<0.05）.The pairwise comparison of the all groups showed that there was significant difference between each group（p<0.05）.2.This study showed that the plasma GDF-15 content was weak inverse correlation with LVEF and weak direct correlation with c Tn I in patients with coronary heart disease,and had no correlation with NT-pro BNP.3.There were significant differences in GDF-15,NT-pro BNP and c Tn I between patients with heart failure after acute myocardial infarction and patients without heart failure after acute myocardial infarction（p<0.05）.4.Whether or not heart failure occurs after acute myocardial infarction as dependent variable,logistic regression analysis showed that plasma GDF-15（OR:1.002,95%CI:1.001-1.004,p=0.013）and NT-pro BNP（OR:1.004,95%CI:1.001-1.007,p=0.006）level were independent predictors of heart failure after acute myocardial infarction.5.The ROC curves were plotted to evaluate the diagnostic value of plasma GDF-15 and NT-pro BNP level for heart failure after acute myocardial infarction,The area under the ROC curve(AUC_ROC)of plasma GDF-15 was0.700,the AUC_ROCof NT-pro BNP was 0.774,and ROC_AUCof the combined detection was 0.887.Conclusion1.GDF-15 to be associated with disease severity in coronary heart disease.2.GDF-15 is an independent predictor of heart failure occurs after acute myocardial infarction.3.The level of GDF-15 and NT-pro BNP are determine simultaneously that can improve the diagnostic effect of heart failure after acute myocardial infarction.