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SHR Neuro Cancer Cardio Lipid Metab Microb
Nopp, S; Moik, F; Kraler, S; Englisch, C; Preusser, M; von, Eckardstein, A; Pabinger, I; Lüscher, TF; Ay, C.
Growth differentiation factor-15 and prediction of cancer-associated thrombosis and mortality: a prospective cohort study.
J Thromb Haemost. 2023; 21(9):2461-2472
Doi: 10.1016/j.jtha.2023.04.043
Web of Science
PubMed
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- Co-authors Med Uni Graz
- Kraler Simon
- Moik Florian
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- Abstract:
- BACKGROUND: Patients with cancer are at increased risk of venous thromboembolism (VTE) and arterial thromboembolic/thrombotic events (ATEs). Growth differentiation factor-15 (GDF-15) improves cardiovascular risk assessment, but its predictive utility in patients with cancer remains undefined. OBJECTIVES: To investigate the association of GDF-15 with the risks of VTE, ATE, and mortality in patients with cancer and its predictive utility alongside established models. METHODS: The Vienna Cancer and Thrombosis Study (CATS)-a prospective, observational cohort study of patients with newly diagnosed or recurrent cancer-which was followed for 2 years, served as the study framework. Serum GDF-15 levels at study inclusion were measured, and any association with VTE, ATE, and death was determined using competing risk (VTE/ATE) or Cox regression (death) modeling. The added value of GDF-15 to established VTE risk prediction models was assessed using the Khorana and Vienna CATScore. RESULTS: Among 1531 included patients with cancer (median age, 62 years; 53% men), median GDF-15 levels were 1004 ng/L (IQR, 654-1750). Increasing levels of GDF-15 were associated with the increased risks of VTE, ATE, and all-cause death ([subdistribution] hazard ratio per doubling, 1.16 [95% CI, 1.03-1.32], 1.30 [95% CI, 1.11-1.53], and 1.57 [95% CI, 1.46-1.69], respectively). After adjustment for clinically relevant covariates, the association only prevailed for all-cause death (hazard ratio, 1.21; 95% CI, 1.10-1.33) and GDF-15 did not improve the performance of the Khorana or Vienna CATScore. CONCLUSION: GDF-15 is strongly associated with survival in patients with cancer, independent of the established risk factors. While an association with ATE and VTE was identified in univariable analysis, GDF-15 was not independently associated with these outcomes and failed to improve established VTE prediction models.
- Find related publications in this database (using NLM MeSH Indexing)
- Humans - administration & dosage
- Venous Thromboembolism - administration & dosage
- Prospective Studies - administration & dosage
- Neoplasms - complications, diagnosis
- Thrombosis - diagnosis, complications
- Risk Factors - administration & dosage
- Growth Differentiation Factors - administration & dosage
- Growth Differentiation Factor 15 - administration & dosage
- Find related publications in this database (Keywords)
- biomarkers
- cancer
- growth differentiation factor 15
- neoplasm
- thromboembolism
- thrombosis