Abstract 18455: Growth-Differentiation Factor 15 Predicts Adverse Cardiac Events in Adults With Congenital Heart Disease
Introduction: Growth-differentiation factor 15 (GDF-15) is a cytokine which is strongly upregulated upon tissue injury and inflammatory states. It offers prognostic information in coronary heart disease and chronic heart failure; however, its usefulness as biomarker in adults with congenital heart disease is unknown.
Hypothesis: GDF-15 is independently associated with adverse cardiac events in adults with congenital heart disease.
Methods: We prospectively included consecutive patients who routinely visited the adult congenital cardiology outpatient clinic between April 2011 and April 2013. At the same day, patients underwent clinical examination, electrocardiography, echocardiography and venous blood sampling. Plasma GDF-15 was measured by batch analyses. The primary endpoint was a composite of ‘death or heart failure’ and the secondary endpoint was a composite of ‘death, heart failure, hospitalization, arrhythmia, thromboembolic event or cardiac re-intervention’. Cox regression was used to assess the predictive value of GDF-15, adjusted for age, sex, systemic ventricular function and NT-proBNP.
Results: In total, 587 patients were included (median age 33 [IQR 25-41] years, 58% male, 90% NYHA class I). Patients were followed for a median of 42 [IQR 37-46] months. GDF-15 was independently associated with the primary endpoint (n=48, adjusted hazard ratio per two-fold increase 1.60 [95% CI 1.13-2.26], P = 0.008) and with the secondary endpoint (n=160, adjusted hazard ratio per two-fold increase 1.34 [95% CI 1.09-1.65], P = 0.006). The discriminatory value (c-statistic) of GDF-15 for the primary and secondary endpoint was 0.79 (95% CI 0.73-0.85) and 0.64 (95% CI 0.59-0.68), respectively.
Conclusions: GDF-15 provides prognostic information, independent of age, sex, systemic ventricular function and NT-proBNP. Therefore, GDF-15 could play an important role in the monitoring and management of adults with congenital heart disease.
Author Disclosures: V.J. Baggen: None. A.E. van den Bosch: None. J.A. Eindhoven: None. E. Boersma: None. J.W. Roos-Hesselink: None.
- © 2016 by American Heart Association, Inc.