Research GDF-15 Levels And Serum Year Prognosis Of Acute Coronary Syndrome

ObjectivesGrowth differentiation factor15(GDF-15) is a member of the transforming growth factor-β superfamily. GDF-15is induced in the myocardium after ischemia-and-reperfusion injury and due to’stess’. GDF-15may protect heart through anti-apoptotic and anti-hypertrophic actions. It may protect from macrophage accumulation and stabilize fibrous cap within atherosclerotic lesions.We explored the one-year prognostic utility of GDF-15in ACS patients. We were also interested to see if GDF-15could add prognostic information in patient subgroups defined by established clinical and biochemical markers, such as BNP、hsCRP etc.Methods and ResultsWe recruited41STEMI patients、45NSTEMI patients and168UAP patients. The serum GDF-15assay was constructed using ELISA method. Clinical and biochemical information was recorded and all patientes were followed up. The serum GDF-15was significantly different between AMI patients and UAP patients. The level of GDF-15was positively related with BNP and peak cTnI. Patients with high level of GDF-15had high incidence of composite endpoint of death, non-fatal myocardial infarction, heart faliure or readmission due to severe angina pectoris at one-year follow-up. The ability of either one of the clinical or biochemical markers—BNP,hsCRP, TIMI class and the number of di seased coronary arteries to predict the composite endpoint was markedly improved by addition of GDF-15.ConclusionsGDF-15is related to myocardium ischemia and injury. High level of serum GDF-15in ACS patients indicates bad one-year prognosis. Combination of GDF-15and established markers has clinical significance in evaluating the long term outcom of ACS.