Growth differentiation factor-15 and prediction of cancer-associated thrombosis and mortality : a prospective cohort study
Copyright © 2023 International Society on Thrombosis and Haemostasis. Published by Elsevier Inc. All rights reserved..
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.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:21 |
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| Enthalten in: |
Journal of thrombosis and haemostasis : JTH - 21(2023), 9 vom: 15. Sept., Seite 2461-2472 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Nopp, Stephan [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 21.08.2023 Date Revised 28.08.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.jtha.2023.04.043 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM356953068 |
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| 100 | 1 | |a Nopp, Stephan |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Growth differentiation factor-15 and prediction of cancer-associated thrombosis and mortality |b a prospective cohort study |
| 264 | 1 | |c 2023 | |
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| 500 | |a Date Completed 21.08.2023 | ||
| 500 | |a Date Revised 28.08.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 International Society on Thrombosis and Haemostasis. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a biomarkers | |
| 650 | 4 | |a cancer | |
| 650 | 4 | |a growth differentiation factor 15 | |
| 650 | 4 | |a neoplasm | |
| 650 | 4 | |a thromboembolism | |
| 650 | 4 | |a thrombosis | |
| 650 | 7 | |a Growth Differentiation Factors |2 NLM | |
| 650 | 7 | |a Growth Differentiation Factor 15 |2 NLM | |
| 700 | 1 | |a Moik, Florian |e verfasserin |4 aut | |
| 700 | 1 | |a Kraler, Simon |e verfasserin |4 aut | |
| 700 | 1 | |a Englisch, Cornelia |e verfasserin |4 aut | |
| 700 | 1 | |a Preusser, Matthias |e verfasserin |4 aut | |
| 700 | 1 | |a von Eckardstein, Arnold |e verfasserin |4 aut | |
| 700 | 1 | |a Pabinger, Ingrid |e verfasserin |4 aut | |
| 700 | 1 | |a Lüscher, Thomas F |e verfasserin |4 aut | |
| 700 | 1 | |a Ay, Cihan |e verfasserin |4 aut | |
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