| Objective The expression level of growth differentiation factor(GDF-15)in peripheral venous blood of patients with acute coronary syndrome(ACS)was measured to compare the efficacy of GDF-15 with different conventional myocardial markers in the diagnosis of ACS,and to explore the value and clinical application of GDF-15 in the early diagnosis of ACS in people with emergency high-risk chest pain.Methods This study collected 136 patients with acute chest pain who presented to the Emergency Department in Hainan Hospital of PLA General Hospital from July 2022 to December 2022 for inclusion in the study.Those enrolled were divided into two groups according to the criteria of the Acute Coronary Syndrome Rapid Care Guidelines(2019):63 in the ACS group and 73 in the non-ACS group;41 healthy subjects who were physically examined at Hainan Hospital of PLA General Hospital during the above time period were selected as the control group.Blood specimens were collected from the included patients according to the standard,centrifuged and the upper plasma layer was aspirated and frozen at-80℃.After all specimens were collected,GDF-15 levels were measured uniformly using the GDF-15 rapid test reagent.Data were statistically processed using SPSS 25.0 software,and differences were considered statistically significant at P<0.05,with a test level of α=0.05.An ROC curve was plotted to assess the diagnostic value of GDF-15 in combination with conventional myocardial markers such as TnT,BNP and CK-MB for ACS.Results 1.Plasma GDF-15 expression levels differed among patients with ACS,patients with non-ACS chest pain and healthy subjects(P<0.05),being 356.69±39.04 pg/mL,230.16 ± 14.93 pg/mL and 120.35±10.91 pg/mL,respectively,and a two-way comparison between groups showed that the expression levels differed between all groups(P<0.05);2.Spearman’s correlation analysis showed that plasma GDF-15 levels in this study were positively correlated with patient age,TnT,BNP,myoglobin and blood creatinine(r>0)and negatively correlated with left ventricular ejection fraction(r<0);3.There was a significant difference between the two groups in terms of history of hypertension,history of prior coronary artery disease,LVEF,GDF-15,TnT,myoglobin and CK-MB(P<0.05);4.According to receiver operating characteristic(ROC)curve,the area under the ROC curve(AUCROC)for plasma GDF-15 alone for the diagnosis of ACS was 0.634(95%CI:0.541-0.728,P<0.05)and the AUCROC for TnT alone for the diagnosis of ACS was 0.716(95%CI:0.622-0.810,P<0.001),while the AUCROC for the combination of both GDF-15 and TnT for the diagnosis of ACS was 0.769(95%CI:0.685-0.853,P<0.001).5 GDF-15 levels of patients in the ACS group were positively correlated with Gensini scores of patients(r=0.363,P<0.05),while a linear relationship between GDF-15 levels and Gensini scores of patients in the ACS group was obtained from linear regression analysis.Conclusions 1.GDF-15 expression levels were elevated in patients with ACS and were significantly different from those in patients with non-ACS-associated chest pain and the healthy population;2.GDF-15 levels were positively correlated with the severity of coronary lesions and the two had a linear relationship.Meanwhile,GDF-15 levels were positively correlated with age,TnT,BNP,Myo and SCr and negatively correlated with left ventricular ejection fraction;3.GDF-15 combined with TnT is of better diagnostic value than TnT alone or GDF-15 alone in people with emergency high-risk chest pain. |
