Growth differentiation factor-15 combined with N-terminal prohormone of brain natriuretic peptide increase 1-year prognosis prediction value for patients with acute heart failure: a prospective cohort study  

作　　者：Ji Hao Iokfai Cheang Li Zhang Kai Wang Hui-Min Wang Qian-Yun Wu Yan-Li Zhou Fang Zhou Dong-Jie Xu Hai-Feng Zhang Wen-Ming Yao Xin-Li Li 

机构地区：[1]Department of Cardiology,The First Affiliated Hospital of Nanjing Medical University,Nanjing,Jiangsu 210029,China [2]Department of Cardiology,The Second Affiliated Hospital of Xuzhou Medical College,Xuzhou,Jiangsu 221002,China

出　　处：《Chinese Medical Journal》2019年第19期2278-2285,共8页中华医学杂志（英文版）

摘　　要：Background:Clinical assessment and treatment guidance for heart failure depends on a variety of biomarkers.The objective of this study was to investigate the prognostic predictive value of growth differentiation factor-15(GDF-15)and N-terminal prohormone of brain natriuretic peptide(NT-proBNP)in assessing hospitalized patients with acute heart failure(AHF).Methods:In total,260 patients who were admitted for AHF in the First Affiliated Hospital of Nanjing Medical University were enrolled from April 2012 to May 2016.Medical history and blood samples were collected within 24 h after the admission.The primary endpoint was the all-cause mortality within 1 year.The patients were divided into survival group and death group based on the endpoint.With established mortality risk factors and serum GDF-15 level,receiver-operator characteristic(ROC)analyses were performed.Cox regression analyses were used to further analyze the combination values of NT-proBNP and GDF-15.Results:Baseline GDF-15 and NT-proBNP were significantly higher amongst deceased than those in survivors(P<0.001).In ROC analyses,area under curve(AUC)for GDF-15 to predict 1-year mortality was 0.707(95%confidence interval[CI]:0.648–0.762,P<0.001),and for NT-proBNP was 0.682(95%CI:0.622–0.738,P<0.001).No statistically significant difference was found between the two markers(P=0.650).Based on the optimal cut-offs(GDF-15:4526.0 ng/L;NT-proBNP:1978.0 ng/L),the combination of GDF-15 and NT-proBNP increased AUC for 1-year mortality prediction(AUC=0.743,95%CI:0.685–0.795,P<0.001).Conclusions:GDF-15,as a prognostic marker in patients with AHF,is not inferior to NT-proBNP.Combining the two markers could provide an early recognition of high-risk patients and improve the prediction values of AHF long-term prognosis.Clinical trial registration:ChiCTR-ONC-12001944,http://www.chictr.org.cn.

关 键 词：Growth differentiation factor-15 Heart failure N-TERMINAL pro-B type NATRIURETIC PEPTIDE PROGNOSIS 

分 类 号：R54[医药卫生—心血管疾病]