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The Prognostic Values of GDF-15 in Comparison with NT-proBNP in Patients with Normotensive Acute Pulmonary Embolism by Latif Duran, Servet Kayhan, Aygul Guzel, Meltem Ince, Celal Kati, Hizir Ufuk Akdemir, Yucel Yavuz, Halit Zengin, Ali Okuyucu, Naci Murat

Background: An early prediction of prognosis in pulmonary embolism (PE) is a crucial clinical entity. The aim of the study is to investigate whether growth differentiation factor-15 (GDF-15) or N-terminal pro-brain natriuretic peptide levels (NT-proBNP) can better predict the 30 day overall mortality in patients with normotensive acute PE.
Methods: Patients with a high clinical probability of PE, or with low/intermediate probability and a positive Ddimer test, underwent contrast-enhanced computed tomography and ventilation/perfusion lung scan. Simplified pulmonary embolism severity index, the presence of echocardiographic right ventricular dysfunction, and ROC curve analysis by calculated cut-off value of serum GDF-15 and NT-proBNP levels were evaluated for each individual of study population.
Results: The serum levels of GDF-15 and NT-proBNP were found to be significantly higher in patients with PE compared with controls (p < 0.0001). In this study, GDF-15 provided better results compared to NT-proBNP in predicting the short term or 30 day mortality (p = 0.046 and p = 0.418, respectively). Serum GDF-15 with a cut-off value of > 2943 pg/mL yielded a 75% sensitivity, 68.7% specificity, 91.6% negative predictive value, and 90% accuracy for predicting 30 day overall mortality. The results of these tests were found as 62.5%, 40.6%, 81.2%, and 40% for NT-proBNP (with the cut-off value of > 1409 pg/mL), respectively.
Conclusions: High serum GDF-15 levels may provide better information than NT-proBNP for early death in the subjects with normotensive PE and these patients should be closely followed up.

DOI: 10.7754/Clin.Lab.2013.130827