Current, Former Smoking Status Linked with Mortality Marker

New research suggests that growth differentiation factor 15 (GDF-15), a mortality marker, is present in both current and former smokers with coronary artery disease.

Researchers for the study looked at a prospective cohort of 2,418 patients with suspected or known coronary artery disease. They measured GDF-15 levels in 955 never-smokers, 1,035 former smokers, and in 428 current smokers enrolled in the ANOX (Development of Novel Biomarkers Related to Angiogenesis or Oxidative Stress to Predict Cardiovascular Events) study. The authors followed participants out to three years (patient age ranged from 19 to 94, with 67.2% of participants being male).

According to the results, never-smokers exhibited significantly lower levels of GDF-15 than former and current smokers. Following stepwise multiple linear regression analysis, log-transformed GDF-15 levels were significantly current and former smoking. GDF-15 levels were significantly associated with all-cause mortality after adjustment for confounders, and the link was significant in all three study groups. GDF-15 did provide incremental prognostic information for the model with potential confounders and traditional cardiovascular biomarkers in patients who never smoked, but not in former or current smokers.

“This is the first, dedicated and large‐scale prospective cohort study to demonstrate that higher levels of GFD-15 are independently associated not only with current smoking, but also with former smoking, and that the prognostic value of GDF-15 on mortality is attenuated in current and former smokers with suspected or known coronary artery disease,” the researchers wrote.

The researchers went on to explain the potential implications of the study results.

“An elevated GDF-15 level in sera from an arterial catheter sheath at the beginning of elective coronary angiography is independently associated with all‐cause mortality in patients with suspected or known coronary artery disease beyond the potential clinical confounders, N‐terminal pro‐B‐type natriuretic peptide, contemporary sensitive cardiac troponin‐I, and high‐sensitivity C‐reactive protein, and this association is most pronounced in never smokers,” they wrote. “Further studies will be needed to clarify the relationships among smoking status, duration and intensity of smoking, body mass index, GDF-15, and mortality/cardiovascular events.”

The analysis was published in the Journal of the American Heart Association.