{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T21:45:17Z","timestamp":1792446317548,"version":"4.5.0"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2014,11,1]],"date-time":"2014-11-01T00:00:00Z","timestamp":1414800000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/501100004830","name":"Siemens","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004830","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004337","name":"Roche","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004337","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","award":["R00-HL107642"],"award-info":[{"award-number":["R00-HL107642"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002347","name":"BMBF","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002347","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","award":["K23-HL116780"],"award-info":[{"award-number":["K23-HL116780"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2014,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>BACKGROUND<\/jats:title>\n                  <jats:p>Biomarkers of cardiovascular stress have been associated with incident cardiovascular outcomes. Their relations with measures of subclinical atherosclerosis, as assessed by carotid intima-media thickness, have not been well described.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>We measured plasma growth differentiation factor-15 (GDF-15), soluble ST2 (sST2), and high-sensitivity troponin I (hsTnI) in 3111 Framingham Offspring participants who also underwent carotid ultrasonography during the sixth examination (1995\u20131998, mean age 58 years, 54% women). Carotid measurements included maximal internal carotid artery (ICA) intima-media thickness (IMT), plaque presence (defined as ICA IMT &amp;gt;1.5 mm), and mean common carotid artery IMT. We carried out multivariable regressions for carotid measurements vs biomarkers using linear and logistic models; P &amp;lt; 0.0056 was deemed statistically significant.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Maximal ICA IMT was significantly associated with plasma GDF-15 [\u03b2-estimate 0.04 per 1-U increase in log(GDF-15), SE 0.01, P &amp;lt; 0.0001]. Similarly, the odds of having carotid plaque increased 33% [odds ratio 1.33 per 1-U increase in log(GDF-15), 95% CI 1.20\u20131.48, P &amp;lt; 0.0001]. In contrast, there was no significant association of maximal ICA IMT or plaque presence with sST2 or hsTnI, and none of the 3 biomarkers was significantly associated with mean CCA IMT. GDF-15 was a stronger predictor of maximal ICA thickness and plaque presence compared with BNP and CRP when these conventional biomarkers were tested together.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Increased GDF-15 concentrations are associated with subclinical atherosclerosis, including maximal ICA IMT and carotid plaque presence. Future studies investigating the role of GDF-15 for screening and management of patients with subclinical atherosclerosis are warranted.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1373\/clinchem.2014.227116","type":"journal-article","created":{"date-parts":[[2014,9,19]],"date-time":"2014-09-19T00:59:38Z","timestamp":1411088378000},"page":"1402-1408","source":"Crossref","is-referenced-by-count":27,"title":["Biomarkers of Cardiovascular Stress and Subclinical Atherosclerosis in the Community"],"prefix":"10.1093","volume":"60","author":[{"given":"Deepa M","family":"Gopal","sequence":"first","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin G","family":"Larson","sequence":"first","affiliation":[{"name":"Framingham Heart Study of the National Heart, Lung, and Blood Institute and Boston University School of Medicine, Framingham, MA"},{"name":"Department of Mathematics and Statistics, Boston University, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James L","family":"Januzzi","sequence":"first","affiliation":[{"name":"Cardiology Division, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Cheng","sequence":"first","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA"},{"name":"Framingham Heart Study of the National Heart, Lung, and Blood Institute and Boston University School of Medicine, Framingham, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anahita","family":"Ghorbani","sequence":"first","affiliation":[{"name":"Department of Medicine, Mount Auburn Hospital, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai C","family":"Wollert","sequence":"first","affiliation":[{"name":"Division of Molecular and Translational Cardiology, Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tibor","family":"Kempf","sequence":"first","affiliation":[{"name":"Division of Molecular and Translational Cardiology, Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralph B","family":"D'Agostino","sequence":"first","affiliation":[{"name":"Framingham Heart Study of the National Heart, Lung, and Blood Institute and Boston University School of Medicine, Framingham, MA"},{"name":"Department of Mathematics and Statistics, Boston University, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph F","family":"Polak","sequence":"first","affiliation":[{"name":"Department of Radiology, Tufts Medical Center, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasan S","family":"Ramachandran","sequence":"first","affiliation":[{"name":"Framingham Heart Study of the National Heart, Lung, and Blood Institute and Boston University School of Medicine, Framingham, MA"},{"name":"Cardiology and Preventive Medicine and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas J","family":"Wang","sequence":"first","affiliation":[{"name":"Framingham Heart Study of the National Heart, Lung, and Blood Institute and Boston University School of Medicine, Framingham, MA"},{"name":"Division of Cardiovascular Medicine, Division of Medicine, Vanderbilt University, Nashville, TN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer E","family":"Ho","sequence":"first","affiliation":[{"name":"Framingham Heart Study of the National Heart, Lung, and Blood Institute and Boston University School of Medicine, Framingham, MA"},{"name":"Cardiovascular Medicine Section, Department of Medicine, Boston University School of Medicine, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2014,11,1]]},"reference":[{"key":"2020022705532166100_B1","doi-asserted-by":"crossref","first-page":"1885","DOI":"10.1161\/01.ATV.14.12.1885","article-title":"Common carotid intima-media thickness and lower extremity arterial atherosclerosis. 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