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Editorial

The Report Card on Growth Differentiation Factor 15

Consistent Marks But Not Yet Ready for Promotion

Anand Rohatgi, MD and James A. de Lemos, MD

From the Donald W. Reynolds Cardiovascular Clinical Research Center (A.R., J.A.d.L.), and the Cardiovascular Division (D.W.R., J.A.d.L.), University of Texas Southwestern Medical Center, Dallas, Tex.

Correspondence to Anand Rohatgi, MD, Division of Cardiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Room HA9.133, Dallas, TX 75390-9047. Email anand.rohatgi@utsouthwestern.edu

Key Words: biomarkers • coronary disease • mortality • myocardial infarction • risk prediction

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
In the present era that includes multiple potential treatment strategies for patients with acute and chronic coronary artery disease (CAD), a primary goal is to match the intensity of therapy with an individual patient’s risk for an adverse outcome. To accomplish this goal, improved risk stratification algorithms are needed. Among the potential strategies to improve risk assessment, measurement of circulating biomarkers offers several advantages, including wide availability and the potential to serially assess evolving pathophysiology. Of the many biomarkers studied for this purpose, however, only a few have demonstrated clear clinical utility.

Article see p 286

Cardiac troponins I and T are well-established biomarkers of myocardial necrosis and have been validated for risk stratification in patients with acute coronary syndromes (ACS). Most (but not all) studies have concluded that higher risk patients identified on the basis of troponin elevation derive greater relative and absolute benefit from more intensive ACS therapies.^1–3 Higher levels of the neurohormones brain natriuretic peptide (BNP) and N-terminal pro-BNP have also been consistently demonstrated to associate with increased risk of mortality and heart failure in patients with ACS and chronic CAD, but studies to date have shown disappointing results regarding a link to treatment outcomes.^4–6 In this issue of Circulation: Cardiovascular Genetics, Kempf et al⁷ report the prognostic impact of a very interesting novel biomarker, growth differentiation factor 15 (GDF-15), in patients with both stable angina pectoris and ACS, providing an excellent framework to explore the performance criteria that should be used to assess the potential . . . [Full Text of this Article]

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