The coronary collateral circulation can reduce sudden cardiac death,myocardial cell loss,and infarct size.Growth differentiation factor 15(GDF-15),a member of the transforming growth factor-β (TGF-β) superfamily,has been reported to have a prognostic predicting value in coronary artery disease.

Hypothesis: GDF-15 can be related with the extent of collateral formation.

Objective: Growth differentiation factor 15 (GDF-15), a member of the transforming growth factor-β (TGF-β) superfamily, has been reported to have a prognostic predicting value in coronary artery disease. We sought to investigate whether GDF-15 is related to coronary collateral development in patients with coronary heart disease.

Methods: A cross-sectional study was performed in 201 patients, who were admitted for selective coronary angiography. Patients were divided into 3 groups based on Rentrop’s classification of coronary collaterals.
Group 1: patients with coronary collateral presence, which was defined by Rentrop’s grade 1–3 collateral development.
Group 2: patients with grade 0 collateral development. Group 3: control group were patients with a normal coronary angiogram. The levels of plasma GDF-15, asymmetric dimethylarginine (ADMA), and soluble Fms-related tyrosine kinase-1 (sFLT-1) were compared among the 3 groups.

Results: There were significant statistical differences in plasma sFLT-1, ADMA, and GDF-15 concentrations among the different collateral groups. The correlations between Rentrop’s grade and the cytokines were significant. A positive correlation was found between Rentrop’s grade and GDF-15 (r = 0.187, P < 0.05). The correlations between the levels of plasma sFLT-1, ADMA, and Rentrop’s grade were significant, with the correlation coefficient of r = 0.181, P < 0.05 (sFLT-1) and r = ?0.646, P < 0.001 (ADMA), respectively.

Conclusions: Our findings suggest that GDF-15 levels increase with the extent of collateral formation. In that case, the patients with a higher level of GDF-15 may predictmore severe coronary stenosis,which has a higher probability to develop collaterals.