Journal of thrombosis and haemostasis : JTH · 2026
Growth differentiation factor-15 and bleeding risk in patients with venous thromboembolism.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Hoberstorfer Timothy, Nopp Stephan, Steiner Daniel, Englisch Cornelia, Kienzl Philip, Weber Benedikt, Fritzer-Szekeres Monika, Pabinger Ingrid, Ay Cihan
Аннотация
BACKGROUND: Growth differentiation factor-15 (GDF-15) has been proposed as a bleeding biomarker.
OBJECTIVES: To evaluate the predictive value of GDF-15 for clinically relevant bleeding (CRB, major bleeding and clinically relevant non-major bleeding) during anticoagulation for venous thromboembolism (VTE).
METHODS: This study was part of BACH-VTE, a cohort study including patients with acute, symptomatic pulmonary embolism or deep vein thrombosis with 2 years of follow-up. Patients with active cancer and pregnant/peripartum were excluded. GDF-15 was measured at baseline and 3 months. CRB cumulative incidences and regression models were adjusted for competing risks (death/anticoagulation stop). The performance of the VTE-PREDICT bleeding risk score with and without GDF-15 and the ABC-bleeding risk score, which includes GDF-15, was analyzed by assessing discrimination, calibration, and overall performance.
RESULTS: Among 383 patients (39.2% female, median age 55 years, 48.0% with pulmonary embolism), 49 first CRB occurred (median follow-up: 178 days), corresponding to a 1-year cumulative incidence of 11.9% (95% confidence interval [95% CI]: 8.7-15.7). Median GDF-15 levels were 968 (interquartile range, 645-1554) pg/mL at baseline and 836 (597-1292) pg/mL at 3 months. Baseline GDF-15 was not associated with CRB in the univariable or multivariable model (subdistribution hazard ratio 1.05 [95% CI: 0.76-1.46] and 0.96 [95% CI: 0.70-1.30] per doubling, adjusted for bleeding history, age, and sex). Accordingly, GDF-15 did not meaningfully improve the predictive performance of VTE-PREDICT. ABC-bleeding showed modest discrimination for CRB in this cohort.
CONCLUSION: In patients receiving anticoagulation for acute VTE, GDF-15 was not associated with CRB and did not improve bleeding prediction.
OBJECTIVES: To evaluate the predictive value of GDF-15 for clinically relevant bleeding (CRB, major bleeding and clinically relevant non-major bleeding) during anticoagulation for venous thromboembolism (VTE).
METHODS: This study was part of BACH-VTE, a cohort study including patients with acute, symptomatic pulmonary embolism or deep vein thrombosis with 2 years of follow-up. Patients with active cancer and pregnant/peripartum were excluded. GDF-15 was measured at baseline and 3 months. CRB cumulative incidences and regression models were adjusted for competing risks (death/anticoagulation stop). The performance of the VTE-PREDICT bleeding risk score with and without GDF-15 and the ABC-bleeding risk score, which includes GDF-15, was analyzed by assessing discrimination, calibration, and overall performance.
RESULTS: Among 383 patients (39.2% female, median age 55 years, 48.0% with pulmonary embolism), 49 first CRB occurred (median follow-up: 178 days), corresponding to a 1-year cumulative incidence of 11.9% (95% confidence interval [95% CI]: 8.7-15.7). Median GDF-15 levels were 968 (interquartile range, 645-1554) pg/mL at baseline and 836 (597-1292) pg/mL at 3 months. Baseline GDF-15 was not associated with CRB in the univariable or multivariable model (subdistribution hazard ratio 1.05 [95% CI: 0.76-1.46] and 0.96 [95% CI: 0.70-1.30] per doubling, adjusted for bleeding history, age, and sex). Accordingly, GDF-15 did not meaningfully improve the predictive performance of VTE-PREDICT. ABC-bleeding showed modest discrimination for CRB in this cohort.
CONCLUSION: In patients receiving anticoagulation for acute VTE, GDF-15 was not associated with CRB and did not improve bleeding prediction.