Plasma growth differentiation factor 15 predicts first-ever stroke in hypertensive patients

被引：16

作者：

Wang, Xiaojian ^{[1
,2
]}

Zhu, Ling ^{[3
]}

Wu, Yan ^{[2
,4
]}

Sun, Kai ^{[1
,2
]}

Su, Ming ^{[1
,2
]}

Yu, Liping ^{[1
,2
]}

Chen, Jingzhou ^{[1
,2
]}

Li, Weiju ^{[5
]}

Yang, Jing ^{[5
]}

Yuan, Zuyi ^{[3
]}

Hui, Rutai ^{[1
,2
]}

机构：

[1] Chinese Acad Med Sci, Natl Ctr Cardiovasc Dis, Fuwai Hosp, State Key Lab Cardiovasc Dis, Beijing, Peoples R China

[2] Peking Union Med Coll, Beijing, Peoples R China

[3] Xi An Jiao Tong Univ, Sch Med, Affiliated Hosp 1, Dept Cardiovasc Med, Xian, Shanxi, Peoples R China

[4] Chinese Acad Med Sci, Natl Ctr Cardiovasc Dis, Fuwai Hosp, Dept Cardiovasc Internal Med, Beijing, Peoples R China

[5] Peking Univ Hosp, Dept Cardiol, Beijing, Peoples R China

来源：

MEDICINE | 2016年 / 95卷 / 30期

基金：

中国国家自然科学基金;

关键词：

first-ever stroke; growth differentiation factor 15; hypertension; ISCHEMIC-STROKE; BETA SUPERFAMILY; HEART; ASSOCIATION; PREVENTION; STATEMENT; DISEASE; MEMBER; RISK; CARE;

D O I：

10.1097/MD.0000000000004342

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Growth differentiation factor 15 (GDF-15) is a relatively new biomarker that predicts adverse stroke outcomes. However, the association of GDF-15 with first-ever stroke in hypertensive patients has not yet been evaluated. The objective of this study was to evaluate the clinical implications of plasma GDF-15 on the development of first-ever stroke in patients with hypertension. In total, 254 patients with hypertension without a history of stroke were included from March 2010 to August 2010 and followed up until June 2013. The baseline circulating GDF-15 was determined by enzyme-linked immunosorbent assays. During a follow-up of 3.0 +/- 0.6 years, 22 (8.7%) first-ever strokes were identified, including 12 ischemic strokes and 10 intracerebral hemorrhages (ICH). According to tertiles of GDF-15, survival free of first-ever stroke was lower in the highest tertile of GDF-15 (log-rank P=0.001). By backward stepwise Cox-regression analysis, adjusted for age, gender, diabetes mellitus, hyperlipidemia, hypertension stage, body mass index, cigarette smoking, anti-hypertensive drugs, and uric acid, every 100pg/mL-increase in plasma of GDF-15 predicted an 11% greater risk of first-ever stroke (hazard ratios [HR]: 1.11, 95% confidence interval [CI]: 1.03-1.20, P=0.010) and an 18% increase in ischemic stroke risk (HR: 1.18, 95% CI: 1.07-1.30, P=0.001). Receiver operating characteristic analysis indicated that GDF-15 had reasonable accuracy to predict first-ever stroke (area under curve=0.73, 95% CI: 0.62-0.83, P<0.001). This study identifies that GDF-15 is an independent predictor of first-ever stroke, especially for ischemic stroke in the patients with hypertension.

引用

页数：6