Abstract Number: OC 17.1
Meeting: ISTH 2022 Congress
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.
To cite this abstract in AMA style:Krivosheeva E, Komarov A, Dobrovolsky A, Titaeva E, Pogorelova O, Balakhonova T, Panchenko E. Growth differentiation factor-15 is related to adverse prognosis in patients with polyvascular disease receiving dual antithrombotic therapy [abstract]. https://abstracts.isth.org/abstract/growth-differentiation-factor-15-is-related-to-adverse-prognosis-in-patients-with-polyvascular-disease-receiving-dual-antithrombotic-therapy/. Accessed September 21, 2023.
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