Growth differentiation factor-15 is a biomarker for all-cause mortality but less evident for cardiovascular outcomes: A prospective study

Previous studies have proposed growth differentiation factor-15 (GDF-15) as a predictor of adverse cardiovascular outcomes and mortality. The present study aimed to determine if such associations remain after accounting for death competing risk, GDF-15 provides superior prediction performance than other biomarkers. Plasma levels risk factors were measured in individuals without diseases (n = 4,143, aged 57.4 ± 5.96 years, 38.6 % men) from Malmö Diet Cancer-Cardiovascular Cohort followed up more 20 years. Incidence coronary events, ischemic stroke, mortality, all-cause mortality was studied relation using Cox proportional hazards regression, with adjustment potential confounders. Confounding carefully checked the Fine Gray subdistribution hazard model. Predictive capabilities further evaluated C-statistics, continuous net reclassification improvement, integrated discrimination improvement. During follow-up, 424 327 368 deaths, 1,308 deaths occurred. After controlling causes only remained significantly related GDF-15. addition improved traditional factors, high-sensitive C-reactive protein N-terminal prohormone brain natriuretic peptide. Only peptide CVD is robust biomarker but less reliable event, stroke or Competing an important consideration when interpreting results.