Author + information
- Mei Yi,
- Michelle Chan,
- Rajalakshmi Santhanakrishnan,
- Jenny PC Chong,
- Tze P Ng,
- Lieng H Ling,
- David Kheng Leng Sim,
- Kui Toh Gerard Leong,
- Poh Shuan Daniel Yeo,
- Hean Y Ong,
- Fazlur Jaufeerally,
- Raymond Wong,
- Ping Chai,
- Adrian F Low,
- Arthur Mark Richards and
- Carolyn SP Lam
Prognostic significance of growth differentiation factor 15 (GDF15) and its short term change, in heart failure with preserved (HFPEF) vs reduced ejection fraction (HFREF) is not fully understood.
Circulating GDF15 and N Terminal pro B type Natriuretic Peptide (NTproBNP) were measured at baseline in patients with HFREF (EF<50%; n=246; age 60±11), HFPEF (EF≥50%; n=47; age 68±11) and controls without HF (n=238; age 59±10). In a subset of 191 patients (164 HFREF, 27 HFPEF), GDF15 was re-measured at 6 weeks. Subjects were followed up for death or HF hospitalization.
At baseline, median GDF15 was similarly elevated in HFPEF (2978ng/L) and HFREF (2685ng/L) compared to controls (609ng/L) (both P<0.001 vs controls; HFPEF vs HFREF P=1.0). Higher GDF15 correlated with higher age, lower glomerular filtration rate, diabetes and higher NTproBNP (all P<0.03). Over a 1 year period, there were 108 events (90 HFREF, 16 HFPEF, 2 controls). Higher GDF15 was associated with higher event rate (P<0.001) (Figure 1), adjusting for age, sex, cardiovascular risk factors and NTproBNP (adjusted HR 2.46 per 1Ln U; P=0.001). The risk was similar for HFPEF and HFREF (interaction P=0.33). In the subset of 191 patients, the mean % change in GDF15 over 6 weeks was small (−9±43%) and did not independently relate to events.
GDF15 is elevated in HFREF and HFPEF at presentation, remains relatively stable over 6 weeks, and provides prognostic information at 1 year independent of clinical risk factors and NTproBNP.
Poster Sessions, Expo North
Sunday, March 10, 2013, 3:45 p.m.-4:30 p.m.
Session Title: New Paradigms in Prognostic Role of Biomarkers in Heart Failure
Abstract Category: 15. Heart Failure: Clinical
Presentation Number: 1265-310
- 2013 American College of Cardiology Foundation