GDF-15 plasma levels in chronic obstructive pulmonary disease are associated with subclinical coronary artery disease

Table 2 Adjusted associations of GDF-15 levels and of cardiovascular risk with CAC score among COPDGene participants with COPD (n = 694)

	Model 1^a	Model 2^b	Model 3^c	Model 4^d
GDF-15 level (in tertiles)
Lower tertile	Ref.	Ref.	Ref.	Ref.
Intermediate tertile	2.52 (1.10, 2.71)	2.30 (1.19, 4.44)	2.16 (1.11, 4.20)	1.87 (0.88, 3.99)
Higher tertile	5.70 (3.08, 10.56)	4.53 (2.40, 8.54)	4.22 (2.20, 8.07)	4.28 (2.09, 8.76)
Coronary heart disease risk group^e
Low (<10%)		Ref.	Ref.	Ref.
Intermediate (10%-20%)		1.49 (0.86, 2.57)	1.46 (0.83, 2.58)	1.33 (0.69, 2.55)
High (>20%)		2.89 (1.45, 5.77)	3.77 (1.79, 7.94)	3.97 (1.68, 9.35)

All entries represent risk ratio of being in the higher group of CAC and its 95% CI, based on multinomial logistic regression models, in which GDF-15 tertiles are compared again the lower tertile as reference, and the groups of cardiovascular risk by the HEART score are compared with the low-risk group as reference. ^aModel 1: Bivariate. ^bModel 2: Model 1 additionally adjusted for baseline coronary heart disease risk group. ^cModel 3: Model 2 additionally adjusted for race, GOLD spirometry stage, pack-years smoked, chronic bronchitis symptoms, history of exacerbations, measures of emphysema and airway thickness, and co-morbidities (asthma, GERD, mobility-related diseases). ^dModel 4: Model 3 additionally adjusted for N-terminal pro–B-type natriuretic peptide, troponin T and Interleukin-6. ^eBased on the HEART score, as described in the Methods section

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