Ceelen, Daan (2022) Discharge GDF-15 predicts post-discharge outcomes in acute heart failure in non-diabetics, but not diabetics. thesis, Medicine.
Full text available on request.Abstract
Introduction: Hospitalization for acute decompensated heart failure (ADHF) is a major healthcare burden and is associated with high post-discharge mortality and rehospitalization rates. Growth differentiation factor-15 (GDF-15) predicts mortality in patients with heart failure (HF), but the predictive value of GDF-15 at discharge from an ADHF hospital admission had not been well established. Methods and results: GDF-15 concentrations were measured at discharge in 875 patients out of the 6545 patients from a randomized clinical trial in patients with ADHF (74±16 years old; 60% male). Patients with higher discharge GDF-15 concentrations were older and more likely to have diabetes or atrial fibrillation/flutter and had higher N-terminal (NT)-pro hormone BNP (NT-proBNP) and lower estimated glomerular filtration rates. Higher discharge GDF-15 was a predictor of 180-day all-cause mortality independent of NT-proBNP and Troponin-T (HR=2.68, p=<0.001) but not when also adjusted for an established clinical model (HR=1.23, p=0.491). However, there was a significant interaction between the predictive value of GDF- 15 and the presence or absence of diabetes (p=0.0017). Discharge GDF-15 was a strong and independent predictor of all-cause mortality in non-diabetics (HR=5.36, p=<0.001), but not in patients with diabetes (HR=1.32, p=0.391). Conclusion: In patients who are hospitalized for heart failure, discharge GDF-15 is a strong predictor of all-cause mortality in non-diabetic patients with HF, but not in diabetic patients.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Voors M.D. Ph.D., Professor Adriaan A. and van Essen M.D., Bart and Figarska Ph.D., Dr. Sylwia M. |
| Faculty: | Medical Sciences |
| Date Deposited: | 24 May 2023 11:15 |
| Last Modified: | 24 May 2023 11:15 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3537 |
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