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dc.contributor.authorUeland, Thor
dc.contributor.authorGullestad, Lars
dc.contributor.authorKou, Lei
dc.contributor.authorYoung, James B.
dc.contributor.authorPfeffer, Marc A.
dc.contributor.authorvan Veldhuisen, Dirk J.
dc.contributor.authorSwedberg, Karl
dc.contributor.authorMcmurray, John J. V.
dc.contributor.authorDesai, Akshay S.
dc.contributor.authorAnand, Inderjit S.
dc.contributor.authorAukrust, Pål
dc.date.accessioned2021-11-15T09:23:44Z
dc.date.available2021-11-15T09:23:44Z
dc.date.issued2021-10-05
dc.description.abstractAims - We aimed to assess the value of GDF-15, a stress-responsive cytokine, in predicting clinical outcomes in patients with heart failure (HF) with reduced ejection fraction (HFrEF) and anemia<p> <p>Methods and results - Serum GDF-15 was assessed in 1582 HFrEF and mild-to-moderate anemia patients who where followed for 28 months in the Reduction of Events by Darbepoetin alfa in Heart Failure (RED-HF) trial, an overall neutral RCT evaluating the effect darbepoetin alfa on clinical outcomes in patients with systolic heart failure and mild-to-moderate anemia. Association between baseline and change in GDF-15 during 6 months follow-up and the primary composite outcome of all-cause death or HF hospitalization were evaluated in multivariable Cox-models adjusted for conventional clinical and biochemical risk factors. The adjusted risk for the primary outcome increased with (i) successive tertiles of baseline GDF-15 (tertile 3 HR 1.56 [1.23–1.98] p < 0.001) as well as with (ii) a 15% increase in GDF-15 levels over 6 months of follow-up (HR 1.68 [1.38–2.06] p < 0.001). Addition of change in GDF-15 to the fully adjusted model improved the C-statistics (p < 0.001). No interaction between treatment and baseline or change in GDF-15 on outcome was observed. GDF-15 was inversely associated with several indices of anemia and correlated positively with ferritin.<p> <p>Conclusions - In patients with HF and anemia, both higher baseline serum GDF-15 levels and an increase in GDF-15 during follow-up, were associated with worse clinical outcomes. GDF-15 did not identify subgroups of patients who might benefit from correction of anemia but was associated with several indices of anemia and iron status in the HF patients.en_US
dc.identifier.citationUeland, Gullestad, Kou, Young, Pfeffer, van Veldhuisen, Swedberg, Mcmurray, Desai, Anand, Aukrust. Growth differentiation factor 15 predicts poor prognosis in patients with heart failure and reduced ejection fraction and anemia: results from RED-HF. Clinical Research in Cardiology. 2021:1-11en_US
dc.identifier.cristinIDFRIDAID 1952498
dc.identifier.doi10.1007/s00392-021-01944-6
dc.identifier.issn1861-0684
dc.identifier.issn1861-0692
dc.identifier.urihttps://hdl.handle.net/10037/22984
dc.language.isoengen_US
dc.publisherSpringeren_US
dc.relation.journalClinical Research in Cardiology
dc.rights.accessRightsopenAccessen_US
dc.rights.holderCopyright 2021 The Author(s)en_US
dc.subjectVDP::Medical disciplines: 700::Basic medical, dental and veterinary science disciplines: 710en_US
dc.subjectVDP::Medisinske Fag: 700::Basale medisinske, odontologiske og veterinærmedisinske fag: 710en_US
dc.titleGrowth differentiation factor 15 predicts poor prognosis in patients with heart failure and reduced ejection fraction and anemia: results from RED-HFen_US
dc.type.versionpublishedVersionen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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