Growth differentiation factor 15 and geriatric conditions in acute coronary syndrome

Autores de INCLIVA

• 

  Juan Sanchis Fores

  Autor

• Vicente Ruiz Ros

  Autor

• 

  Clara Bonanad Lozano

  Autor

• Clara Sastre Arbona

  Autor

• Macarena Díaz Giménez

  Autor

• Enrique Rodriguez Borja

  Autor

• Ernesto Valero Picher

  Autor

• Sergio Garcia Blas

  Autor

• Arturo Carratalá Calvo

  Autor

• 

  Julio Nuñez Villota

  Autor

Participantes ajenos a INCLIVA

• Ruescas, A
• Nunez, E

Grupos y Plataformas de I+D+i

• Grupo de investigación en Cardiología Clínica

  

  Leading Researcher

  Juan Sanchis Fores

• Grupo de Investigación Traslacional en Cardiopatía Isquémica

  

  Leading Researcher

  Vicent Bodí Peris

Abstract

Background: Growth differentiation factor 15 (GDF-15) is a marker of cell senescence. Age is a well-known determinant of GDF-15 levels, yet no study has analyzed the relationship between geriatric conditions and GDF-15. We hypothesize that geriatric conditions reflecting biological age might be stronger determinants of GDF-15 than chronological age in elderly patients with acute coronary syndrome. Methods: A total of 208 patients (mean age = 78.3 +/- 7.0 years) were included. Prior to discharge, a thorough geriatric assessment was performed and GDF-15 measured. Predictors of GDF-15 (transformed by its natural logarithm) were determined with linear regression. Furthermore, Cox regression was used for the analysis of all-cause mortality. The median follow-up was 728 days. Results: Median GDF-15 concentration was 2432 pg/ml. In multivariate analysis, frailty (Fried score, p = 0.001), and comorbidity (Charlson index, p = 0.003) were independent determinants of lnGDF-15 while age was not significant (p = 0.17). Other covariates included in the model were male gender (p = 0.017), diabetes (p = 0.169), Killip class >= 2 (p = 0.046) and glomerular filtration rate (p = 0.001). The Fried score and Charlson index provided significant incremental value in the R-2 model (0.362 vs 0.447; p = 0.0001). A total of 66 (32%) patients died. LnGDF-15 was a significant mortality predictor (HR = 1.82, 95% CI 1.12-2.94, p = 0.015) along with the Fried score (p = 0.013) and the Charlson index (p = 0.030). Conclusions: Geriatric conditions are strong determinants of GDF-15 levels on top of age in acute coronary syndromes. Furthermore, GDF-15 was associated with mortality independently of geriatric status. Geriatric assessment and GDF-15 are complementary tools. (C) 2019 Elsevier B.V. All rights reserved.

© 2019 Elsevier B.V. All rights reserved

Keywords

• Growth differentiation factor 15; Elderly; Acute coronary syndrome