GDF15型
医学
心力衰竭
内科学
比例危险模型
危险系数
混淆
射血分数
利钠肽
心脏病学
多元分析
生存分析
置信区间
作者
Yoichiro Otaki,Mari Shimizu,Tetsu Watanabe,Shingo Tachibana,Junya Sato,Yuta Kobayashi,Tomonori Aono,Shigehiko Kato,H. Tamura,Satoshi Nishiyama,Takanori Arimoto,Hiroki Takahashi,Masafumi Watanabe
出处
期刊:Circulation journal
[The Japanese Circulation Society]
日期:2023-07-25
卷期号:87 (8): 1120-1129
被引量:1
标识
DOI:10.1253/circj.cj-23-0088
摘要
Heart failure (HF) is an increasing health problem associated with a high mortality rate. Growth differentiation factor (GDF) 15, a stress response cytokine belonging to the transforming growth factor-β superfamily, is associated with poor clinical outcomes in a broad spectrum of cardiovascular diseases. However, the prognostic usefulness of GDF15 in Japanese patients with HF remains unclear.Methods and Results: We measured serum concentrations of GDF15 and B-type natriuretic peptide (BNP) in 1,201 patients with HF. All patients were prospectively followed for a median period of 1,309 days. In all, 319 HF-related events and 187 all-cause deaths occurred during the follow-up period. Kaplan-Meier analysis demonstrated that, among GDF15 tertiles, the highest tertile group had the greatest risk of HF-related events and all-cause mortality. Multivariate Cox proportional hazard regression analysis demonstrated that the serum GDF15 concentration was an independent predictor of HF-related events and all-cause deaths after adjusting for confounding risk factors. Serum GDF15 improved the prediction capacity for all-cause deaths and HF-related events with a significant net reclassification index and integrated discrimination improvement. Subgroup analysis in patients with HF with preserved ejection fraction also showed the prognostic usefulness of GDF15.Serum GDF15 concentrations were associated with HF severity and clinical outcomes, indicating that GDF15 could provide additional clinical information to track the health status of patients with HF.
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