EGFR And GDF-15 Are The Independent Risk Factors For MACE In Patients With CHD In Chinese Population On Clinical Research

Objective:1. Analysis the effect of eGFR and GDF-15 on forecast and assessment about MACE in patients with CHD;2. To combine the traditional risk factors with the novel risk factors of CHD, in order to provide the basis of experiment and clinical aspects for MACE;Methods:1. Patients: from January 2012 to December 2013, 3700consecutive patients with CHD were admitted to the Department of Cardiology in Chinese PLA General Hospital (Beijing, China) at 3.5-year-follow-up.CHD included stable angina pectoris, unstable angina pectoris, myocardial infarction (MI), percutaneous coronary intervention(PCI) patients and CABG patients.2. Set up specimen database: clinical data, including age, gender, contact information, cardiovascular risk factors, physical examination, medical therapy at discharge, coronary angiogram, the result of carotid ultrasound were all collected. Also, we collected blood and urine samples of all the patients.3. Test conventional indicators/ biochemical indicators/novel plasma markers: the conventional indicators and biochemical indicators contain blood routine test,fasting blood glucose, creatinine, CK-MB, total cholesterol, triglyceride, HDL,LDL, lp(a), cystatin-c, glycosylated hemoglobin, coagulation convention, uric acid, and so on. Estimated GFR CKD-EPI (ml/min/ 1.73 m2) was calculated from standardized serum creatinine (Scr, mg/dl). ELISA was used for testing GDF-15.4. Data management and statistical analysis: all data was recorded used excel. The SPSS 20.0 statistical software package (SPSS Inc., Chicago, Illinois) and STATA was used for all calculations.Result:1. During 3.5-year follow-up, 450 patients (12.2%) enrolled combined events,whereas 3250 patients did not. MACEs was defined as the combined result of cardiovascular death, all-cause mortality, nonfatal myocardial infarction, stoke,heart failure or peripheral arterial embolism.2. Patients who developed MACE had a lower eGFR compared to that of non-MACE patients. On cox regression analysis, only eGFR levels (p <0.05) and age(p<0.01) remained independent predictors of the MACE. The area under the curve of eGFR (0.71, 95% confidence interval: (0.68, 0.74)) was significantly greater with MACE.3. On cox regression analysis, GDF-15 was linked to MACE (P<0.05). The area under the curve of GDF-15 (area under the curve is 0.71, 95% confidence interval: (0.69, 0.74)) was associated with MACE after3.5-year-follow-up.When divided into four parts, we can report that a higher level of GDF-15 was significantly associated with MACE than lower level.Conclusion:1. In patients with CHD, a lower level of eGFR and a higher level of GDF-15 are independently associated with an increased risk of MACE during 3.5-year follow up.2. Compared with other traditional markers, eGFR and GDF-15 levels significantly increase risk of MACE.3. eGFR negatively links to GDF-15.