Growth Differentiation Factor-15 (GDF-15) as a Predictor of Major Adverse Cardiac Event in Acute Myocardial Infarction Patients

BACKGROUNDGrowth Differentiation Factor-15 (GDF-15) has emerged as a biomarker that capable to predicting cardiovascular events. Recent studies suggest that GDF-15 is elevated in patients with acute myocardial infarction (AMI), but the prognostic remains incompletely defined. This study aimed to investigate the role of GDF-15 levels with major cardiac adverse events (MACE) on three months follow up in patients with AMI. METHODSThis cohort study was conducted from November 2020 until May 2021 at Dr. Moewardi Hospital. GDF-15 was measured at admission, clinical data was collected and 3 months follow up events was registered. Prognostic value of GDF-15 and hazard ratio between high and low GDF-15 level were analyzed. RESULTSA total of 64 AMI patients were included in this study. MACE at three months follow-up occurred in 26.5% of patients. In multivariate analysis, GDF-15 was independently associated with risk of MACE at 3 months follow up (OR 1.501; p = 0.003). The cut-off point value of GDF-15 was analyzed with the ROC curve, obtained 2256 pg/mL which has a sensitivity of 94.1% and a specificity of 73.8% (area under the curve (AUC) 86.2%; 95% CI 0.768-0.956). Risk model with Kapplan Meier showed significant association between high GDF-15 levels (≥ 2256 pg/mL) and the incidence of MACE at 3 months follow up (HR 12.029; 95% CI 3.429- 42.197; p