Evidence suggests that elevated serum GDF-15, together with 1-antitrypsin and glutathione peroxidase 1 (GPx-1) levels, are associated with a high risk of acute coronary syndrome, a phenomenon that occurs just during early heart failure in asymptomatic patients and for the risk stratification of patients with the acute coronary syndrome, endothelial dysfunction [12, 13]. Here, GPX1 is linked to endothelial dysfunction.