Targeted multiple biomarker approach in predicting cardiovascular events in patients with diabetes

Abstract

GDF-15 and hs-TnT are strong independent cardiovascular biomarkers augmenting the predictive value of NT-proBNP in patients with diabetes.

Association of growth-differentiation factor-15 with the number of circulating proangiogenic endothelial progenitor cells in patients with type 2 diabetes mellitus

“…Whether GDF-15 could be involved as the protector from atherosclerotic injury with similar molecular mechanisms as mentioned above is not sufficiently clear. Although some scientists reported that levels of GDF-15 in people with diabetes demonstrated the close positive association with traditional CV risk factors, such as LDL cholesterol, BMI, age, inflammatory activity, but not with TG [14,15]. The results of our study well correspond with these findings, and we yielded that GDF-15 could be a component of the endogenous vascular repair system that maintains vascular integrity and function.…”

Cardiovascular biomarkers in clinical studies of type 2 diabetes

“…EDTA plasma produces predictably lower NT‐proBNP values (10%‐13%) than those observed in serum or heparin plasma, which may be explained by NT‐proBNP fragmentation after samples are drawn . Additionally, heparinized whole blood can be analysed in point‐of‐care systems, a portable device measuring NT‐proBNP in real time . The ideal handling of BNP and NT‐proBNP samples in order to minimize pre‐analytical variations is not fully established .…”

The Growth/Differentiation Factor-15 in Chronic Heart Failure: New Challenge in Biomarker-Guided Therapy?

“…Moreover, GDF-15 has able to identify a vulnerable subjects in general population without known CV disease, prediabetes and diabetes mellitus [23]. Resl, et al [25] reported that elevated level of GDF-15 have independently associated with subsequent CV event and 10-year all-cause mortality even after adjusting for well-established CV risk factors and widely used cardiac biomarkers (NT-pro brain NP, cardiac troponins, hs-C-reactive protein). However, there is not agreement regarding an issue about whether or not that an elevated GDF-15 level in peripheral blood is adaptive response in HF individuals aiming recovery of vascular function.…”

“…cardiac hypertrophy, HF, atherosclerosis, stable coronary artery disease, myocardial infarction, as well as in hypertension, diabetes mellitus, abdominal obesity, chronic kidney disease, and malignancy [22][23][24]. Recent clinical studies have shown that GDF-15 independently predicted allcause mortality rate and CV death rate in patients with coronary artery disease, atrial fibrillation and HFpEF and HFrEF [24,25]. Moreover, GDF-15 has able to identify a vulnerable subjects in general population without known CV disease, prediabetes and diabetes mellitus [23].…”

“…Contrary, GDF-15-related recruitment of EPCs may be a powerful mechanism of endothelial repair and maintenance vascular function if development and progression of HF. Finally, GDF-15 is probably not good target for biomarkerguided therapy, although there are some investigations with opposite conclusions [24,25]. Although elevated level of GDF-15 associated with HF development, progression, and prognosis, there is not represented evidence regarding direct comparison of this biomarker with other clinical risk predictors and biomarkers [35].…”