Abstract:Background
There is evidence suggesting that growth differentiation factor 15 (GDF‐15) appears to be associated with stroke in patients with atrial fibrillation (AF). AF‐related thromboembolic stroke is predominantly attributed to the thrombus from the left atrium (LA) or left atrial appendage (LAA).
Hypothesis
GDF‐15 is related to LA/LAA thrombus in nonvalvular AF (NVAF) patients.
Methods
A total of 894 patients with NVAF without anticoagulation therapy were included in this study. All patients routinely unde… Show more
“…Plenty of clinical research has been conducted to explore the relationship between GDF‐15 levels and CVDs. These experiments conclusively demonstrate that GDF‐15 levels link to the adverse cardiovascular events across a spectrum of CVD conditions including heart failure (HF), chest pain, acute coronary syndromes (ACS), stable ischemic heart disease, stroke, and atrial fibrillation . The potential ability of GDF‐15 may attribute to the earlier diagnosis, risk stratification and prognosis assessment.…”
Background and Aim
Previous studies have documented that the association between growth differentiation factor‐15 (GDF‐15) the risk of patients with cardiovascular diseases (CVDs). In this meta‐analysis, our main objective is to explore the associations between GDF‐15 and the risk of CVD or all‐cause mortality.
Methods
PubMed and ISI Web of Science (up to January 2018) electronic databases were browsed for eligible studies. The studies provided relevant data depicted as hazard ratio (HR) with 95% confidence interval (CI), with regard to the association between GDF‐15 levels and subsequent risk of CVDs or all‐cause mortality. A random‐effect model was applied to pool the HR and 95% CI.
Results
Thirty‐one prospective studies met the eligibility criteria involving 53 706 subjects with 7020 adverse outcome events. It was concluded that GDF‐15 levels were associated with an incremental risk of CVDs or all‐cause mortality. Highest GDF‐15 category was associated with greater risk of cardiovascular mortality (HR, 2.66; 95% CI, 1.69‐3.63), all‐cause mortality (HR, 2.52; 95% CI, 2.06‐2.97), and complex adverse outcome (HR, 1.81; 95% CI, 1.42‐2.21). As each log‐unit increment in GDF‐15 concentration, the corresponding risk of adverse events also escalated, cardiovascular mortality (HR, 2.11; 95% CI, 1.57‐2.66), all‐cause mortality (HR, 2.70; 95% CI, 2.29‐3.12), and complex adverse outcome (HR, 1.96; 95% CI, 1.64‐2.29).
Conclusions
Judging from the results of the data analysis, GDF‐15 levels may increase the risk of CVDs or all‐cause mortality.
“…Plenty of clinical research has been conducted to explore the relationship between GDF‐15 levels and CVDs. These experiments conclusively demonstrate that GDF‐15 levels link to the adverse cardiovascular events across a spectrum of CVD conditions including heart failure (HF), chest pain, acute coronary syndromes (ACS), stable ischemic heart disease, stroke, and atrial fibrillation . The potential ability of GDF‐15 may attribute to the earlier diagnosis, risk stratification and prognosis assessment.…”
Background and Aim
Previous studies have documented that the association between growth differentiation factor‐15 (GDF‐15) the risk of patients with cardiovascular diseases (CVDs). In this meta‐analysis, our main objective is to explore the associations between GDF‐15 and the risk of CVD or all‐cause mortality.
Methods
PubMed and ISI Web of Science (up to January 2018) electronic databases were browsed for eligible studies. The studies provided relevant data depicted as hazard ratio (HR) with 95% confidence interval (CI), with regard to the association between GDF‐15 levels and subsequent risk of CVDs or all‐cause mortality. A random‐effect model was applied to pool the HR and 95% CI.
Results
Thirty‐one prospective studies met the eligibility criteria involving 53 706 subjects with 7020 adverse outcome events. It was concluded that GDF‐15 levels were associated with an incremental risk of CVDs or all‐cause mortality. Highest GDF‐15 category was associated with greater risk of cardiovascular mortality (HR, 2.66; 95% CI, 1.69‐3.63), all‐cause mortality (HR, 2.52; 95% CI, 2.06‐2.97), and complex adverse outcome (HR, 1.81; 95% CI, 1.42‐2.21). As each log‐unit increment in GDF‐15 concentration, the corresponding risk of adverse events also escalated, cardiovascular mortality (HR, 2.11; 95% CI, 1.57‐2.66), all‐cause mortality (HR, 2.70; 95% CI, 2.29‐3.12), and complex adverse outcome (HR, 1.96; 95% CI, 1.64‐2.29).
Conclusions
Judging from the results of the data analysis, GDF‐15 levels may increase the risk of CVDs or all‐cause mortality.
“…Moreover, in the multivariate linear regression, statistically signi cant linear and negative relationship of GDF-15 with PBMC telomerase activity, telomere length, and hTERT mRNA expression were observed. GDF-15 is stress-induced factor, the biological roles of GDF-15 are context-dependent and may vary with the stage of the disease [19][20][21]. In a systematic research, aimed to identify genes regulated in aging, and age-related diseases, GDF-15 is one of the high priority candidates [13].…”
Background: The aging process is accompanied by the gradual development of chronic systemic inflammation (inflamm-aging). Growth differentiation factor-15 (GDF-15) is associated with inflammation and known to be a stress-induced factor. The present study aimed to explore the association of GDF-15 with aging.Methods: In this cross-sectional study, serum GDF-15, hematological parameters, and biomedical parameters were determined in 120 healthy individuals (23-83 years old, males). Three telomere related parameters, including telomere length, telomerase activity, and the expression of human telomerase reverse transcriptase (hTERT) mRNA were also quantified.Results: The older group has a higher levels of GDF-15 and lower expression of hTERT mRNA, and PBMC telomerase activity (p<0.001). In individuals with high GDF-15 levels, they were older, and presented with the lower level of hTERT mRNA and T/S ratio (p<0.01). Spearman correlation analysis shows that GDF-15 positively correlated with age (r=0.664, p<0.001), and negatively correlated with telomere length (r=-0.434, p<0.001), telomerase activity (r=-0.231, p=0.012), and hTERT mRNA (r=-0.206, p=0.024). Furthermore, in multivariate regression analysis, GDF-15 levels showed a statistically significant linear and negative relationship with PBMC telomerase activity (β-coefficient=-0.583, 95% CI -1.044 to -0.122, p=0.014), telomere length (β-coefficient=-0.200, 95% CI -0.305 to -0.094, p<0.001), and hTERT mRNA (β-coefficient=-0.207, 95% CI -0.312 to -0.102, p<0.001) after adjusting for confounders.Conclusions: In conclusion, our results show that circulating GDF-15 is the potential biomarkers of aging that may influence the risk and progression of multiple aging conditions.
“…Moreover, GDF-15 was also shown to be an independent risk factor for stroke in patients with AF (99). After adjusting for potential clinical risk factors, GDF-15 was associated with LAA thrombus in patients with nonvalvular AF (100) (Central Illustration). Central IllustrationAtrial Myopathy: Its Relationship Between Atrial Fibrillation and StrokesAtrial myopathy is typically caused by insults such as aging, inflammation, oxidative stress, and stretching of the atria.…”
Section: Atrial Myopathy: Its Interplay Between Af and Strokementioning
HighlightsThe authors discuss the concept of atrial myopathy; its relationship to aging, electrophysiological remodeling, and autonomic remodeling; the interplay between atrial myopathy, AF, and stroke; and suggest how to identify patients with atrial myopathy and how to incorporate atrial myopathy into decisions about anticoagulation.Atrial myopathy seen in animal models of AF and in patients with AF is the result of a combination of factors that lead to electrical and structural remodeling in the atrium. Although AF may lead to the initiation and/or progression of this myopathy, the presence of AF is by no means essential to the development or the maintenance of the atrial myopathic state.Methods to identify atrial myopathy include atrial electrograms, tissue biopsy, cardiac imaging, and certain serum biomarkers. A promising modality is 4-dimensional flow cardiac magnetic resonance. The concept of atrial myopathy may help guide oral anticoagulant therapy in selected groups of patients with AF, particularly those with low to intermediate risk of strokes and those who have undergone successful AF ablation. This review highlights the need for prospective randomized trials to test these hypotheses.
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