Karaji, I;
Steiro, O-T;
Myrmel, GMS;
Omland, T;
Tjora, HL;
Langørgen, J;
Bjørneklett, R;
Skadberg, Ø;
Bonarjee, VVS;
Mjelva, ØR;
et al.
Karaji, I; Steiro, O-T; Myrmel, GMS; Omland, T; Tjora, HL; Langørgen, J; Bjørneklett, R; Skadberg, Ø; Bonarjee, VVS; Mjelva, ØR; Collinson, P; Vikenes, K; Larsen, TH; Aakre, KM; Pedersen, ER
(2025)
Limited incremental value of growth differentiation factor 15 in the initial evaluation of low and intermediate risk acute chest pain patients.
CLINICAL BIOCHEMISTRY, 137.
p. 110926.
ISSN 0009-9120
https://doi.org/10.1016/j.clinbiochem.2025.110926
SGUL Authors: Collinson, Paul
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Abstract
Introduction Expression of the cytokine growth differentiation factor 15 (GDF-15) is up-regulated in conditions of tissue injury and stress. We evaluated if GDF-15 predicts obstructive coronary artery disease (CAD) or need for revascularization within 30 days and 12 months in low/intermediate risk patients with acute chest pain. Materials and Methods We included 537 hospitalized patients who had high-sensitivity troponin T (hs-cTnT) < 99th percentile and underwent coronary CT angiography (CCTA). Odds ratios (ORs) and 95 % confidence intervals (CI) were calculated by logistic regression analyses and are reported per standard deviation increment of GDF-15 (log-transformed). Results The median (25th-75th percentile) age was 56 (49–65) years, 217 (40.4 %) were women, 83 (15.5 %) had obstructive CAD at CCTA. In total 49 (9.1 %) patients underwent revascularization within 30 days and 52 (9.7 %) within 12 months. In age and sex adjusted analysis GDF-15 was a significant predictor with ORs (95 % CI) of 1.35 (1.05–1.73), 1.39 (1.06–1.83) and 1.41 (1.07–1.84) for obstructive CAD, revascularization within 30 days and 12 months, respectively. However, after adjustment for clinical covariables, the ORs of GDF-15 were no longer statistically significant for either outcome (P ≥ 0.07). Adding hs-cTnT levels alone to the age and sex adjusted model also rendered the ORs of GDF-15 non-significant (P ≥ 0.31). Conclusions In patients with acute chest pain but without acute myocardial infarction, GDF-15 did not substantially improve the identification of obstructive CAD or need for revascularization within 30 days and 12 months. Our findings question the clinical usefulness of GDF-15 for prognostication of low-risk patients with acute chest pain.
Item Type: | Article | ||||||||||||
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Additional Information: | © 2025 The Authors. Published by Elsevier Inc. on behalf of The Canadian Society of Clinical Chemists. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). | ||||||||||||
Keywords: | Biomarkers, Acute chest pain, GDF-15, High-sensitivity troponin, Rule-in/Rule-out algorithm, CCTA, Prognostication | ||||||||||||
SGUL Research Institute / Research Centre: | Academic Structure > Cardiovascular & Genomics Research Institute Academic Structure > Cardiovascular & Genomics Research Institute > Clinical Cardiology |
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Journal or Publication Title: | CLINICAL BIOCHEMISTRY | ||||||||||||
ISSN: | 0009-9120 | ||||||||||||
Language: | en | ||||||||||||
Publisher License: | Creative Commons: Attribution 4.0 | ||||||||||||
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URI: | https://openaccess.sgul.ac.uk/id/eprint/117547 | ||||||||||||
Publisher's version: | https://doi.org/10.1016/j.clinbiochem.2025.110926 |
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