Objectives Growth differentiation factor-15 (GDF-15) has emerged as a novel biomarker for coronary artery disease (CAD). Although a hypercoagulable state is recognized as a biological mechanism triggering cardiac events in CAD, the relationship between GDF-15 and coagulation parameters in CAD patients remains unclear.

Methods We screened male patients who underwent elective coronary angiography for suspected CAD at Renmin Hospital of Wuhan University between January 2020 and December 2020, and enrolled those with confirmed diagnoses. Serum GDF-15 levels, blood cell counts, glucose, serum lipids, and coagulation parameters were measured.

Results A total of 892 subjects were included (592 CAD patients and 300 controls). The CAD group comprised 161 stable angina (SA) and 431 acute coronary syndrome (ACS) cases. Data were analyzed using Kruskal–Wallis one-way ANOVA with post hoc tests (Holm–Sidak and Dunn’s tests). Compared with controls, CAD patients showed significantly higher serum GDF-15 levels. When stratified by GDF-15 tertiles, patients with high GDF-15 levels exhibited prolonged prothrombin time (PT) and activated partial thromboplastin time (APTT), elevated fibrinogen and D-dimer levels, and reduced antithrombin III (AT3) activity (all P<0.01). Multiple linear regression revealed that GDF-15 was independently associated with fibrinogen in all CAD patients (β=0.208, P<0.001) as well as in SA (β=0.171, P=0.035) and ACS subgroups (β=0.163, P=0.006). Additionally, GDF-15 negatively correlated with AT3 in the ACS subgroup (β= −0.120, P=0.039).

Conclusions Elevated GDF-15 levels in male CAD patients are associated with altered coagulation parameters, suggesting that GDF-15 may serve as a potential indicator of thrombosis risk in cardiovascular management.

The authors have declared no competing interest.

This study was funded by Fundamental Research Funds for Central Universities (Grant Number:2042021kf0109)

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Ethics committee of Renmin Hospital of Wuhan University gave ethical approval for this work

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