GDF-15 and the risk of bleeding in patients with stable CAD receiving multicomponent antithrombotic therapy: the results of the prospective REGATA register
- Authors: Krivosheeva E.N.1, Komarov A.L.1, Panchenko E.P.1, Khakimova M.B.1, Kropacheva E.S.1, Pogorelova O.A.1, Balakhonova T.V.1, Titaeva E.V.1, Dobrovolsky A.B.1, Galyautdinov D.M.1, Vlasova E.E.1
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Affiliations:
- Chazov National Medical Research Center of Cardiology
- Issue: Vol 96, No 7 (2024): VARIO
- Pages: 683-689
- Section: Original articles
- URL: https://journals.rcsi.science/0040-3660/article/view/262138
- DOI: https://doi.org/10.26442/00403660.2024.07.202783
- ID: 262138
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Abstract
Aim. To evaluate the prognostic value of GDF-15 in relation the development of bleeding and events in stable CAD patients, receiving combined antithrombotic therapy.
Materials and methods. The data was obtained from the prospective registry REGATA, 343 CAD patients (249 males), median age 68 [IQR 62; 75] years) were enrolled. Patients with sinus rhythm and concomitant PAD received acetylsalicylic acid in combination with rivaroxaban 2.5 mg bid (31.8%) or clopidogrel (24.8%). Other 43.4% with concomitant atrial fibrillation (AF) received direct oral anticoagulants in combination with antiplatelet therapy after elective percutaneous coronary interventions. Median follow-up was 12 months [IQR 9.0; 18.0]. The safety end point was major and clinically relevant bleedings (type 2–5) according to the BARC classification. Plasma samples for GDF-15 identification were taken at the inclusion and analyzed using ELISA assay.
Results. Frequency of BARC 2–5 bleedings was 16% (BARC 2 – 46; BARC 3 – 9; BARC 4–5 – 0), median GDF-15 level was 1185.0 pg/ml [850.0; 1680.0]. In patients with AF and concomitant MFA, the level of GDF-15 was significantly higher than in the subgroups of patients with only AF or MFA (p=0.0022). According to the quintile analysis, GDF-15 values in the top three quintiles of distribution (cut-off value >943 pg/ml) were associated with higher frequency of bleeding events: 23.2% versus 5.1%; p=0.0001. The multivariable logistic regression model demonstrated that bleeding events were independently associated with GDF-15 level>943 pg/ml (OR 2.65, 95% CI 1.11–6.30; p=0.0275), AF (OR 2.61, 95% CI 1.41–4.83; p=0.0023) and chronic kidney disease (OR 1.92, 95% CI 1.03–3.60; p=0.0401). Clinical factors determining the risk of bleeding events also determined a GDF-15 elevation.
Conclusion. Assessment of GDF-15 level may improve bleeding risk stratification in CAD patients with concomitant AF and/or PAD receiving combined antithrombotic therapy.
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##article.viewOnOriginalSite##About the authors
Elena N. Krivosheeva
Chazov National Medical Research Center of Cardiology
Author for correspondence.
Email: lena-4ka@yandex.ru
ORCID iD: 0000-0003-1146-9974
мл. науч. сотр. отд. клинических проблем атеротромбоза
Russian Federation, MoscowAndrey L. Komarov
Chazov National Medical Research Center of Cardiology
Email: lena-4ka@yandex.ru
ORCID iD: 0000-0001-9141-103X
д-р мед. наук, вед. науч. сотр. отд. клинических проблем атеротромбоза
Russian Federation, MoscowElizaveta P. Panchenko
Chazov National Medical Research Center of Cardiology
Email: lena-4ka@yandex.ru
ORCID iD: 0000-0002-1174-2574
д-р мед. наук, проф., рук. отд. клинических проблем атеротромбоза
Russian Federation, MoscowMaria B. Khakimova
Chazov National Medical Research Center of Cardiology
Email: lena-4ka@yandex.ru
ORCID iD: 0000-0001-5404-7216
аспирант отд. клинических проблем атеротромбоза
Ekaterina S. Kropacheva
Chazov National Medical Research Center of Cardiology
Email: lena-4ka@yandex.ru
ORCID iD: 0000-0002-3092-8593
канд. мед. наук, ст. науч. сотр. отд. клинических проблем атеротромбоза
Russian Federation, MoscowOlga A. Pogorelova
Chazov National Medical Research Center of Cardiology
Email: lena-4ka@yandex.ru
ORCID iD: 0000-0001-7897-4727
канд. мед. наук, ст. науч. сотр. отд. ультразвуковых исследований сосудов
Russian Federation, MoscowTatyana V. Balakhonova
Chazov National Medical Research Center of Cardiology
Email: lena-4ka@yandex.ru
ORCID iD: 0000-0002-7273-6979
д-р мед. наук, проф., рук. отд. ультразвуковых исследований сосудов
Russian Federation, MoscowElena V. Titaeva
Chazov National Medical Research Center of Cardiology
Email: lena-4ka@yandex.ru
ORCID iD: 0000-0001-5271-9074
канд. биол. наук, ст. науч. сотр. отд. клинических проблем атеротромбоза
Russian Federation, MoscowAnatoly B. Dobrovolsky
Chazov National Medical Research Center of Cardiology
Email: lena-4ka@yandex.ru
ORCID iD: 0000-0001-5397-6857
д-р биол. наук, проф., гл. науч. сотр. отд. клинических проблем атеротромбоза
Russian Federation, MoscowDamir M. Galyautdinov
Chazov National Medical Research Center of Cardiology
Email: lena-4ka@yandex.ru
ORCID iD: 0000-0002-0257-1398
канд. мед. наук, ст. науч. сотр. отд. сердечно-сосудистой хирургии
Russian Federation, MoscowElina E. Vlasova
Chazov National Medical Research Center of Cardiology
Email: lena-4ka@yandex.ru
ORCID iD: 0000-0003-2925-244X
канд. мед. наук, ст. науч. сотр. отд. сердечно-сосудистой хирургии
Russian Federation, MoscowReferences
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