title: The prognostic values of GDF-15 in comparison with NT-proBNP in patients with normotensive acute pulmonary embolism.
abstract: 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 D-dimer 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.
authors.forename: Latif
authors.initials: L
authors.lastname: Duran
authors.forename: Servet
authors.initials: S
authors.lastname: Kayhan
authors.forename: Aygul
authors.initials: A
authors.lastname: Guzel
authors.forename: Meltem
authors.initials: M
authors.lastname: Ince
authors.forename: Celal
authors.initials: C
authors.lastname: Kati
authors.forename: Hizir Ufuk
authors.initials: HU
authors.lastname: Akdemir
authors.forename: Yucel
authors.initials: Y
authors.lastname: Yavuz
authors.forename: Halit
authors.initials: H
authors.lastname: Zengin
authors.forename: Ali
authors.initials: A
authors.lastname: Okuyucu
authors.forename: Naci
authors.initials: N
authors.lastname: Murat
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D055436:Growth Differentiation Factor 15 / Q000097:blood*; D006801:Humans; D008168:Lung / Q000473:pathology; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D010477:Perfusion; D011237:Predictive Value of Tests; D011336:Probability; D011379:Prognosis; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000097:blood* / Q000175:diagnosis*; D012372:ROC Curve; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods; D055815:Young Adult
chemical_list: C526140:GDF15 protein, human; D055436:Growth Differentiation Factor 15; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain