Open AccessGDF‐15 is a better complimentary marker for risk stratification of arrhythmic death in non‐ischaemic, dilated cardiomyopathy than soluble ST 2
Author(s) -
Stojkovic Stefan,
Kaider Alexandra,
Koller Lorenz,
Brekalo Mira,
Wojta Johann,
Diedrich Andre,
Demyanets Svitlana,
Pezawas Thomas
Publication year - 2018
Publication title -
journal of cellular and molecular medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.44
H-Index - 130
eISSN - 1582-4934
pISSN - 1582-1838
DOI - 10.1111/jcmm.13540
Subject(s) - ejection fraction , medicine , gdf15 , cardiology , hazard ratio , dilated cardiomyopathy , heart failure , sudden cardiac death , risk stratification , cardiomyopathy , confidence interval
Growth differentiation factor ( GDF )‐15 and soluble ST 2 ( sST 2) are established prognostic markers in acute and chronic heart failure. Assessment of these biomarkers might improve arrhythmic risk stratification of patients with non‐ischaemic, dilated cardiomyopathy ( DCM ) based on left ventricular ejection fraction ( LVEF ). We studied the prognostic value of GDF ‐15 and sST 2 for prediction of arrhythmic death ( AD ) and all‐cause mortality in patients with DCM . We prospectively enrolled 52 patients with DCM and LVEF ≤ 50%. Primary end‐points were time to AD or resuscitated cardiac arrest ( RCA ), and secondary end‐point was all‐cause mortality. The median follow‐up time was 7 years. A cardiac death was observed in 20 patients, where 10 patients had an AD and 2 patients had a RCA . One patient died a non‐cardiac death. GDF ‐15, but not sST 2, was associated with increased risk of the AD / RCA with a hazard ratio ( HR ) of 2.1 (95% CI = 1.1‐4.3; P = .031). GDF ‐15 remained an independent predictor of AD / RCA after adjustment for LVEF with adjusted HR of 2.2 (95% CI = 1.1‐4.5; P = .028). Both GDF ‐15 and sST 2 were independent predictors of all‐cause mortality (adjusted HR = 2.4; 95% CI = 1.4‐4.2; P = .003 vs HR = 1.6; 95% CI = 1.05‐2.7; P = .030). In a model including GDF ‐15, sST 2, LVEF and NYHA functional class, only GDF ‐15 was significantly associated with the secondary end‐point (adjusted HR = 2.2; 95% CI = 1.05‐5.2; P = .038). GDF ‐15 is superior to sST 2 in prediction of fatal arrhythmic events and all‐cause mortality in DCM . Assessment of GDF ‐15 could provide additional information on top of LVEF and help identifying patients at risk of arrhythmic death.