Diagnostic value of the gene expression of Growth Differentiation Factor 15 and Telomerase Reverse Transcriptase in middle-aged patients with acute coronary artery disease: a pilot case-control study 

Abstract

<title>Abstract</title> <underline>Background</underline>: Differential diagnosis of the various manifestations of ischaemic heart disease can be difficult, especially in the young, with many investigations being relevant. We hypothesised that expression of the genes for Growth Differentiation Factor 15 (<italic>GDF15</italic>) and Telomerase Reverse Transcriptase (<italic>TERT</italic>) have a place in the diagnosis of an acute coronary artery disease event in those aged up to 55 years with existing coronary artery disease. Venous blood was obtained from 53 patients (27 with diabetes) presenting with an acute coronary syndrome and subsequently shown to have coronary artery disease, and from 46 age and sex matched controls free of cardiovascular disease and its risk factors. Relative expression of leukocyte transcriptome <italic>GAPDH,</italic> <italic>GDF15</italic> and <italic>TERT</italic>were determined by real-time polymerase chain reaction and quantified by quantitation-comparative Ct (ΔCt). <underline>Results:</underline> Compared to controls, mean (95% CI) relative expression of <italic>GDF15</italic> mRNA in the patients was 1.38 (1.13-1.49) (p&lt;0.001), and of <italic>TERT</italic> was 1.12 (1.04-1.20) p=0.003), with <italic>GDF15 </italic>being greater than that of <italic>TERT</italic>(p&lt;0.001). There was no difference in relative <italic>GDF15</italic> expression in 26 patients free of diabetes (1.6 [1.42-1.78]) versus the 27 patients with diabetes (1.6 [1.29-1.91]) (p=0.996), and no difference in relative <italic>TERT</italic>expression in patients free of diabetes (1.19 [1.06-1.33]) compared to those with diabetes (1.25 [0.98-1.50]) (p=0.739). <underline>Conclusions</underline>: Compared to healthy controls, <italic>GDF15</italic> and <italic>TERT</italic> expressions are both increased in coronary artery disease and in coronary artery disease+diabetes, with no difference between the patient groups. These genes may have roles in the diagnosis and pathogenesis of acute coronary artery disease.