OC 17.1 - Growth differentiation factor-15 is related to adverse prognosis in patients with polyvascular disease receiving dual antithrombotic therapy

Sunday, July 10, 2022

10:45 AM – 11:00 AM

Location: ExCel Center, ICC Capital Suite Room 10&11

Presentation Format: Virtual

Presenting Author(s)

Elena Krivosheeva, PhD

junior researcher
NATIONAL MEDICAL RESEARCH CENTER OF CARDIOLOGY Ministry of Health of the Russian Federation
Moscow, Moskva, Russia

Co-Author(s)

AK

Andrey Komarov

leading researcher, MD
NATIONAL MEDICAL RESEARCH CENTER OF CARDIOLOGY Ministry of Health of the Russian Federation, DEPARTMENT OF CLINICAL PROBLEMS OF ATHEROTHROMBOSIS
Moscow, Moskva, Russia
AD

Anatoliy Dobrovolsky

Chief investigator, professor
Federal State Budgetary Institution NATIONAL MEDICAL RESEARCH CENTER OF CARDIOLOGY Ministry of Health
Moscow, Moskva, Russia
ET

Elena Titaeva

senior research associate, PhDs in Medicine
NATIONAL MEDICAL RESEARCH CENTER OF CARDIOLOGY Ministry of Health of the Russian Federation, DEPARTMENT OF CLINICAL PROBLEMS OF ATHEROTHROMBOSIS
Moscow, Moskva, Russia
OP

Olga Pogorelova

Senior Researcher, PhD
NATIONAL MEDICAL RESEARCH CENTER OF CARDIOLOGY Ministry of Health of the Russian Federation, ULTRASOUND DIVISION
Moscow, Moskva, Russia
TB

Tatiana Balakhonova

MD, Professor, Head of the of group of vascular ultrasound
NATIONAL MEDICAL RESEARCH CENTER OF CARDIOLOGY Ministry of Health of the Russian Federation, ULTRASOUND DIVISION
Moscow, Moskva, Russia
EP

Elizaveta Panchenko

MD, Professor, Head of the department
NATIONAL MEDICAL RESEARCH CENTER OF CARDIOLOGY Ministry of Health of the Russian Federation, DEPARTMENT OF CLINICAL PROBLEMS OF ATHEROTHROMBOSIS
Moscow, Moskva, Russia

Background: Polyvascular disease may require long-term dual antithrombotic therapy (DAT) with aspirin and low-dose rivaroxaban. This combination resulted in decrease of thrombotic events at the cost of some excess of major bleedings. We proposed that biochemical markers of vascular damage (growth differentiation factor-15 (GDF-15) and von Willebrand factor (VWF)) may improve risk stratification for better choice of proper treatment regimen.

Aims: To investigate the prognostic value of GDF-15 and VWF levels in patients with chronic polyvascular disease receiving long-term DAT (aspirin+ rivaroxaban 2.5 mg BID).

Methods: Data obtained from single center prospective Registry of Long-term AnTithrombotic TherApy (REGATTA-1 NCT04347200). In this analysis we include subgroup of patients with polyvascular disease (CAD+peripheral atherosclerosis) receiving DAT (n=58; 72,4% males, median age 67 [IQR 62; 70] years). Median duration of follow up period was 10 months [IQR 8.0; 12.0]. Primary outcome was a composite of bleeding (BARC 2-5) and MACE. Plasma samples for GDF-15 and VWF were taken before DAT started and analyzed using ELISA.

Results: Frequency of primary outcome during follow up period was 15.5 % (there were 7 bleeding events and only 2 MACE). Median GDF-15 level was 1147.7 pg/ml [IQR 882.6; 1435.9]. Median VWF level was 157.5% [116.0; 205.0]. According to ROC analysis GDF-15 level>1548 pg/ml (AUC=0.710; p=0.0211; CI 0.576–0.821) and VWF level>157% (AUC=0.701; p=0.0182; CI 0.566–0.814) increase the probability of primary outcome. Event free curves for GDF-15 and VWF levels are shown on the picture. Significant relationship was found between GFD-15 and VWF (r=0.32; p=0.0153). Only GDF-15 level (>1548 pg/ml) remained significant in multiple regression model: OR 11.0; CI 2.20-55.9; р=0.0035.

Conclusion(s): High GDF-15 (>1548 pg/ml) is related to adverse outcomes (mostly, bleeding events) in patients with chronic polyvascular disease receiving long-term DAT.