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Prognostic Value of Serum Growth Differentiation Factor-15 in Patients with Chronic Obstructive Pulmonary Disease Exacerbation

Tuberculosis & Respiratory Diseases / Tuberculosis & Respiratory Diseases,
2014, v.77 no.6, pp.243-250











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Abstract

Background: Information regarding prognostic value of growth differentiation factor 15 (GDF-15) and heart-type fattyacid-binding protein (H-FABP) in patients with chronicobstructive pulmonary disease (COPD) exacerbation is limited. The aim of this study was to investigate whether serum levels of GDF-15 and H-FABP predict an adverse outcome forCOPD exacerbation. Methods: Clinical variables, including serum GDF-15 and H-FABP levels werecompared in prospectively enrolledpatients with COPD exacerbation that did or didnot experience an adverse outcome. An adverse outcome included 30-day mortalityand need for endotracheal intubation or inotropic support. Results: Ninety-seven patients were included and allocated into an adverseoutcome (n=10) or a control (n=87) group. Frequencies of mental change and PaCO2>37 mm Hg were significantly higher in the adverse outcome group (mentalchange: 30% vs. 6%, p=0.034 and PaCO2>37 mm Hg: 80% vs. 22%, p<0.001, respectively). Serum GDF-15 elevation (>1,600pg/mL) was more common in the adverse outcome group (80% vs. 43%, p=0.041). However, serumH-FABP level andfrequency of serum H-FABP elevation (>755 pg/mL) did not differ between the two groups. Multivariate analysis showedthat an elevated serum GDF-15 and PaCO2>37 mm Hg were significant predictors of an adverse outcome (odds ratio[OR],25.8; 95% confidence interval [CI], 2.7−243.8; p=0.005 and OR, 11.8; 95% CI, 1.2−115.3; p=0.034, respectively). Conclusion: Elevated serum GDF-15 level and PaCO2>37 mm Hg were found to predict an adverse outcomeindependently in patients with COPD exacerbation, suggestingthe possibility that serum GDF-15 could be used as aprognostic biomarker of COPD exacerbation.

keywords
Pulmonary Disease, Chronic Obstructive, Disease Progression, Growth Differentiation Factor 15, FABP3 Protein, Human

Reference

1.

1. Murray CJ, Lopez AD. Alternative projections of mortality and disability by cause 1990-2020: Global Burden of Disease Study. Lancet 1997;349:1498-504.

2.

2. Anzueto A. Impact of exacerbations on COPD. Eur Respir Rev 2010;19:113-8.

3.

3. Connors AF Jr, Dawson NV, Thomas C, Harrell FE, Jr., Desbiens N, Fulkerson WJ, et al. Outcomes following acute exacerbation of severe chronic obstructive lung disease. The SUPPORT investigators (Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments). Am J Respir Crit Care Med 1996;154(4 Pt 1):959-67.

4.

4. Groenewegen KH, Schols AM, Wouters EF. Mortality and mortality-related factors after hospitalization for acute exacerbation of COPD. Chest 2003;124:459-67.

5.

5. Singanayagam A, Schembri S, Chalmers JD. Predictors of mortality in hospitalized adults with acute exacerbation of chronic obstructive pulmonary disease. Ann Am Thorac Soc 2013;10:81-9.

6.

6. Stolz D, Breidthardt T, Christ-Crain M, Bingisser R, Miedinger D, Leuppi J, et al. Use of B-type natriuretic peptide in the risk stratification of acute exacerbations of COPD. Chest 2008;133:1088-94.

7.

7. Chang CL, Robinson SC, Mills GD, Sullivan GD, Karalus NC, McLachlan JD, et al. Biochemical markers of cardiac dysfunction predict mortality in acute exacerbations of COPD. Thorax 2011;66:764-8.

8.

8. Baillard C, Boussarsar M, Fosse JP, Girou E, Le Toumelin P, Cracco C, et al. Cardiac troponin I in patients with severe exacerbation of chronic obstructive pulmonary disease. Intensive Care Med 2003;29:584-9.

9.

9. Rammaert B, Verdier N, Cavestri B, Nseir S. Procalcitonin as a prognostic factor in severe acute exacerbation of chronic obstructive pulmonary disease. Respirology 2009;14:969-74.

10.

10. Meadows CA, Risbano MG, Zhang L, Geraci MW, Tuder RM, Collier DH, et al. Increased expression of growth differentiation factor-15 in systemic sclerosis-associated pulmonary arterial hypertension. Chest 2011;139:994-1002.

11.

11. Su AI, Wiltshire T, Batalov S, Lapp H, Ching KA, Block D, et al. A gene atlas of the mouse and human protein-encoding transcriptomes. Proc Natl Acad Sci U S A 2004;101:6062-7.

12.

12. Wollert KC, Kempf T, Peter T, Olofsson S, James S, Johnston N, et al. Prognostic value of growth-differentiation factor-15in patients with non-ST-elevation acute coronary syndrome. Circulation 2007;115:962-71.

13.

13. Kempf T, Bjorklund E, Olofsson S, Lindahl B, Allhoff T, Peter T, et al. Growth-differentiation factor-15 improves risk stratification in ST-segment elevation myocardial infarction. Eur Heart J 2007;28:2858-65.

14.

14. Kempf T, von Haehling S, Peter T, Allhoff T, Cicoira M, Doehner W, et al. Prognostic utility of growth differentiation factor-15 in patients with chronic heart failure. J Am Coll Cardiol 2007;50:1054-60.

15.

15. Lankeit M, Kempf T, Dellas C, Cuny M, Tapken H, Peter T, et al. Growth differentiation factor-15 for prognostic assessment of patients with acute pulmonary embolism. Am J Respir Crit Care Med 2008;177:1018-25.

16.

16. Nickel N, Kempf T, Tapken H, Tongers J, Laenger F, Lehmann U, et al. Growth differentiation factor-15 in idiopathic pulmonary arterial hypertension. Am J Respir Crit Care Med 2008;178:534-41.

17.

17. Alhadi HA, Fox KA. Do we need additional markers of myocyte necrosis: the potential value of heart fatty-acid-binding protein. QJM 2004;97:187-98.

18.

18. Storch J, Thumser AE. The fatty acid transport function of fatty acid-binding proteins. Biochim Biophys Acta 2000;1486:28-44.

19.

19. O’Donoghue M, de Lemos JA, Morrow DA, Murphy SA, Buros JL, Cannon CP, et al. Prognostic utility of heart-type fatty acid binding protein in patients with acute coronary syndromes. Circulation 2006;114:550-7.

20.

20. Dellas C, Puls M, Lankeit M, Schafer K, Cuny M, Berner M, et al. Elevated heart-type fatty acid-binding protein levels on admission predict an adverse outcome in normotensive patients with acute pulmonary embolism. J Am Coll Cardiol 2010;55:2150-7.

21.

21. Puls M, Dellas C, Lankeit M, Olschewski M, Binder L, Geibel A, et al. Heart-type fatty acid-binding protein permits early risk stratification of pulmonary embolism. Eur Heart J 2007;28:224-9.

22.

22. Boscheri A, Wunderlich C, Langer M, Schoen S, Wiedemann B, Stolte D, et al. Correlation of heart-type fatty acid-binding protein with mortality and echocardiographic data in patients with pulmonary embolism at intermediate risk. Am Heart J 2010;160:294-300.

23.

23. Rabe KF, Hurd S, Anzueto A, Barnes PJ, Buist SA, Calverley P, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med 2007;176:532-55.

24.

24. Tillie-Leblond I, Marquette CH, Perez T, Scherpereel A, Zanetti C, Tonnel AB, et al. Pulmonary embolism in patients with unexplained exacerbation of chronic obstructive pulmonary disease: prevalence and risk factors. Ann Intern Med 2006;144:390-6.

25.

25. Choi KJ, Cha SI, Shin KM, Lee J, Hwangbo Y, Yoo SS, et al. Prevalence and predictors of pulmonary embolism in Korean patients with exacerbation of chronic obstructive pulmonary disease. Respiration 2013;85:203-9.

26.

26. Mahler DA, Wells CK. Evaluation of clinical methods for rating dyspnea. Chest 1988;93:580-6.

27.

27. Shorr AF, Sun X, Johannes RS, Yaitanes A, Tabak YP. Validation of a novel risk score for severity of illness in acute exacerbations of COPD. Chest 2011;140:1177-83.

28.

28. Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, et al. Standardisation of spirometry. Eur Respir J 2005;26:319-38.

29.

29. McQuillan BM, Picard MH, Leavitt M, Weyman AE. Clinical correlates and reference intervals for pulmonary artery systolic pressure among echocardiographically normal subjects. Circulation 2001;104:2797-802.

30.

30. Schiller NB, Shah PM, Crawford M, DeMaria A, Devereux R, Feigenbaum H, et al. Recommendations for quantitation of the left ventricle by two-dimensional echocardiography. American Society of Echocardiography Committee on Standards, Subcommittee on Quantitation of Two-Dimensional Echocardiograms. J Am Soc Echocardiogr 1989;2:358-67.

31.

31. Wells JM, Washko GR, Han MK, Abbas N, Nath H, Mamary AJ, et al. Pulmonary arterial enlargement and acute exacerbations of COPD. N Engl J Med 2012;367:913-21.

32.

32. Devaraj A, Wells AU, Meister MG, Corte TJ, Wort SJ, Hansell DM. Detection of pulmonary hypertension with multidetector CT and echocardiography alone and in combination. Radiology 2010;254:609-16.

33.

33. Edwards PD, Bull RK, Coulden R. CT measurement of main pulmonary artery diameter. Br J Radiol 1998;71:1018-20.

34.

34. Shimano M, Ouchi N, Walsh K. Cardiokines: recent progress in elucidating the cardiac secretome. Circulation 2012;126:e327-32.

35.

35. Matkovic Z, Huerta A, Soler N, Domingo R, Gabarrus A, Torres A, et al. Predictors of adverse outcome in patients hospitalised for exacerbation of chronic obstructive pulmonary disease. Respiration 2012;84:17-26.

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