Increased growth differentiation factor 15 is associated with unfavorable clinical outcomes of acute ischemic stroke

Jieyun Yin, Zhengbao Zhu, Daoxia Guo, Aili Wang, Nimei Zeng, Xiaowei Zheng, Yanbo Peng, Chongke Zhong, Guangli Wang, Yiting Zhou, Chung Shiuan Chen, Jing Chen, Yonghong Zhang, Jiang He

Research output: Contribution to journalArticlepeer-review

16 Scopus citations

Abstract

BACKGROUND: Growth differentiation factor 15 (GDF-15), a stress-responsive biomarker, is known to be independently associated with mortality and cardiovascular events in different disease settings, but data on the prognostic value of GDF-15 after stroke are limited. METHODS: Baseline serum GDF-15 was measured in 3066 acute ischemic stroke patients from the China Antihypertensive Trial in Acute Ischemic Stroke (CATIS). The primary outcome was a composite of death and major disability within 3 months. Secondary outcomes included death, major disability, vascular events, and stroke recurrence. The associations between GDF-15 and clinical outcomes after stroke were assessed by multivariate logistic regression or Cox proportional hazards models. RESULTS: At 3 months’ follow-up, 676 (22.05%), 86 (2.80%), 81 (2.64%), and 51 (1.66%) patients had experienced major disability, death, vascular events, or stroke recurrence, respectively. After adjusting for age, sex, current smoking, alcohol consumption, and baseline National Institutes of Health Stroke Scale score, the odds ratio/hazard ratio (95% CI) of 1 SD higher of base-10 log-transformed GDF-15 was 1.26 (1.15–1.39) for primary outcome, 1.13 (1.02–1.25) for major disability, 1.79 (1.48 –2.16) for death, and 1.26 (1.00 –1.58) for vascular events. The addition of GDF-15 to established risk factors improved risk prediction of the composite outcome of death and major disability (c-statistic, net reclassification index, and integrated discrimination improvement, all P 0.05). CONCLUSIONS: High GDF-15 concentrations are independently associated with adverse clinical outcomes of acute ischemic stroke, suggesting that baseline serum GDF-15 could provide additional information to identify ischemic stroke patients at high risk of poor prognosis.

Original languageEnglish (US)
Pages (from-to)569-578
Number of pages10
JournalClinical chemistry
Volume65
Issue number4
DOIs
StatePublished - Apr 2019

ASJC Scopus subject areas

  • General Medicine

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