Growth Differentiation Factor-15 (GDF-15) Is Associated With Mortality in Ischemic Stroke Patients Treated With Acute Revascularization Therapy.
Fiche publication
Date publication
janvier 2019
Journal
Frontiers in neurology
Auteurs
Membres identifiés du Cancéropôle Est :
Pr VERGELY Catherine
Tous les auteurs :
Brenière C, Méloux A, Pédard M, Marie C, Thouant P, Vergely C, Béjot Y
Lien Pubmed
Résumé
Growth differentiation factor-15 (GDF-15) has been identified as a robust marker of developing cardiovascular disease, however, little is currently known about its prognostic value in stroke patients. In a context of growing interest to discover new biomarkers in stroke, we aimed to assess the association between circulating GDF-15 levels and three-month mortality in ischemic stroke patients treated with acute revascularization therapy. 173 patients hospitalized for acute ischemic stroke and treated with either intravenous thrombolysis ( = 99, 57.2%), mechanical thrombectomy ( = 41, 23.4%) or combined therapy ( = 33, 19.1%) were prospectively included. Baseline clinical and biological characteristics were recorded. Plasma GDF-15 levels were measured at admission (D0), and at 24 h, 3 and 7 days. Clinical severity was assessed with the National Institutes of Health Stroke Scale (NIHSS) score, and vital status was obtained 3 months after the stroke. At 3 months post-stroke, 32 patients (18.5%) had died. The deceased patients had higher D0 plasma GDF-15 levels (median [IQR]: 2,777 [1,769-5,446] vs. 1,460 [965-2,079] pg/mL, < 0.001). In multivariable logistic regression analysis, D0 GDF-15 levels in the third tertile of the distribution were independently associated with mortality at 3 months (OR = 3.71; 95% CI: 1.09-12.6, = 0.036), even after adjustment for confounding variables including clinical severity. Our data show for the first time that GDF-15 plasma concentration at admission is independently associated with 3-month mortality in ischemic stroke patients treated with acute revascularization therapy. The pathophysiological mechanisms that could explain this association warrant further study.
Mots clés
GDF15, mortality, stroke, thrombectomy, thrombolysis
Référence
Front Neurol. 2019 ;10:611