Circulating GDF-15 levels predict future secondary manifestations of cardiovascular disease explicitly in women but not men with atherosclerosis
(2017) In International Journal of Cardiology 241. p.430-436- Abstract
Background: Elevated serum levels of growth differentiation factor-15 (GDF-15), is an established risk factor for a range of cardiovascular diseases.We aimed to evaluate the predictive value of plasma GDF-15 as a biomarker for secondary cardiovascular events (CVE) in patients with atherosclerosis undergoing carotid endarterectomy (CEA). Secondly, we determined whether plasma GDF-15 was associated with carotid plaque characteristics. Methods: Circulating GDF-15 levels were determined by Luminex assay in a cohort of 1056 patients from the Athero-Express biobank. Composite endpoint was defined as major CVE, death and peripheral vascular interventions. Findings were validated in 473 patients from the independent Carotid Plaque Imaging... (More)
Background: Elevated serum levels of growth differentiation factor-15 (GDF-15), is an established risk factor for a range of cardiovascular diseases.We aimed to evaluate the predictive value of plasma GDF-15 as a biomarker for secondary cardiovascular events (CVE) in patients with atherosclerosis undergoing carotid endarterectomy (CEA). Secondly, we determined whether plasma GDF-15 was associated with carotid plaque characteristics. Methods: Circulating GDF-15 levels were determined by Luminex assay in a cohort of 1056 patients from the Athero-Express biobank. Composite endpoint was defined as major CVE, death and peripheral vascular interventions. Findings were validated in 473 patients from the independent Carotid Plaque Imaging Project biobank. Results: GDF-15 levels did not associate with secondary CVE in the total cohort. However, following a significant interaction with sex, it was found to be strongly, independently predictive of secondary CVE in women but not men (quartile 4 vs. quartile 1: HR 3.04 [95% CI 1.35-6.86], p = 0.007 in women vs. HR 0.96 [95% CI 0.66-1.40], p = 0.845 in men). This was also observed in the validation cohort (women: HR 2.28 [95% CI 1.04-5.05], p = 0.041), albeit dependent upon renal function. In addition, GDF-15 was associated with the presence of plaque smooth muscle cells and calcification. Conclusion: High circulating GDF-15 levels are predictive of secondary CVE in women but not in men with carotid atherosclerotic disease undergoing CEA, suggesting a potential use for GDF-15 as a biomarker for secondary prevention in women. Sex differences in the role of GDF-15 in atherosclerotic disease deserve further interest.
(Less)
- author
- organization
-
- EXODIAB: Excellence of Diabetes Research in Sweden
- EpiHealth: Epidemiology for Health
- Cardiovascular Research - Translational Studies (research group)
- Cardiovascular Research - Immunity and Atherosclerosis (research group)
- Cardiovascular Research - Cellular Metabolism and Inflammation (research group)
- publishing date
- 2017-03-22
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Atherosclerosis, Biomarker, GDF-15, Prognosis, Secondary outcome, Women
- in
- International Journal of Cardiology
- volume
- 241
- pages
- 430 - 436
- publisher
- Elsevier
- external identifiers
-
- scopus:85017404290
- pmid:28389123
- wos:000405455200074
- ISSN
- 0167-5273
- DOI
- 10.1016/j.ijcard.2017.03.101
- language
- English
- LU publication?
- yes
- id
- 50f0945c-a9c0-4f3b-aadb-285f063b8c1b
- date added to LUP
- 2017-05-02 14:33:17
- date last changed
- 2025-02-03 14:58:53
@article{50f0945c-a9c0-4f3b-aadb-285f063b8c1b, abstract = {{<p>Background: Elevated serum levels of growth differentiation factor-15 (GDF-15), is an established risk factor for a range of cardiovascular diseases.We aimed to evaluate the predictive value of plasma GDF-15 as a biomarker for secondary cardiovascular events (CVE) in patients with atherosclerosis undergoing carotid endarterectomy (CEA). Secondly, we determined whether plasma GDF-15 was associated with carotid plaque characteristics. Methods: Circulating GDF-15 levels were determined by Luminex assay in a cohort of 1056 patients from the Athero-Express biobank. Composite endpoint was defined as major CVE, death and peripheral vascular interventions. Findings were validated in 473 patients from the independent Carotid Plaque Imaging Project biobank. Results: GDF-15 levels did not associate with secondary CVE in the total cohort. However, following a significant interaction with sex, it was found to be strongly, independently predictive of secondary CVE in women but not men (quartile 4 vs. quartile 1: HR 3.04 [95% CI 1.35-6.86], p = 0.007 in women vs. HR 0.96 [95% CI 0.66-1.40], p = 0.845 in men). This was also observed in the validation cohort (women: HR 2.28 [95% CI 1.04-5.05], p = 0.041), albeit dependent upon renal function. In addition, GDF-15 was associated with the presence of plaque smooth muscle cells and calcification. Conclusion: High circulating GDF-15 levels are predictive of secondary CVE in women but not in men with carotid atherosclerotic disease undergoing CEA, suggesting a potential use for GDF-15 as a biomarker for secondary prevention in women. Sex differences in the role of GDF-15 in atherosclerotic disease deserve further interest.</p>}}, author = {{Gohar, Aisha and Gonçalves, Isabel and Vrijenhoek, Joyce and Haitjema, Saskia and van Koeverden, Ian and Nilsson, Jan and de Borst, Gert J. and de Vries, Jean-Paul P. M. and Pasterkamp, Gerard and den Ruijter, Hester M and Björkbacka, Harry and de Jager, Saskia C A}}, issn = {{0167-5273}}, keywords = {{Atherosclerosis; Biomarker; GDF-15; Prognosis; Secondary outcome; Women}}, language = {{eng}}, month = {{03}}, pages = {{430--436}}, publisher = {{Elsevier}}, series = {{International Journal of Cardiology}}, title = {{Circulating GDF-15 levels predict future secondary manifestations of cardiovascular disease explicitly in women but not men with atherosclerosis}}, url = {{http://dx.doi.org/10.1016/j.ijcard.2017.03.101}}, doi = {{10.1016/j.ijcard.2017.03.101}}, volume = {{241}}, year = {{2017}}, }