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Association between growth differentiation factor-15 and adverse outcomes among patients with heart failure: A systematic literature review.

ABSTRACT: Growth differentiation factor-15 (GDF-15) is an emerging biomarker in several conditions. This SLR, conducted following PRISMA guidelines, examined the association between GDF-15 concentration and range of adverse outcomes in patients with heart failure (HF). Publications were identified from Embase® and Medline® bibliographic databases between January 1, 2014, and August 23, 2022 (congress abstracts: January 1, 2020, to August 23, 2022). Sixty-three publications met the eligibility criteria (55 manuscripts and 8 abstracts; 45 observational studies and 18 post hoc analyses of randomized controlled trials [RCTs]). Of the 19 outcomes identified, the most frequently reported longitudinal outcomes were mortality (n = 32 studies; all-cause [n = 27] or cardiovascular-related [n = 6]), composite outcomes (n = 28; most commonly mortality ± hospitalization/rehospitalization [n = 19]), and hospitalization/re-hospitalization (n = 11). The most common cross-sectional outcome was renal function (n = 22). Among longitudinal studies assessing independent relationships with outcomes using multivariate analyses (MVA), a significant increase in risk associated with higher baseline GDF-15 concentration was found in 22/24 (92 %) studies assessing all-cause mortality, 4/5 (80 %) assessing cardiovascular-related mortality, 13/19 (68 %) assessing composite outcomes, and 4/8 (50 %) assessing hospitalization/rehospitalization. All (7/7; 100 %) of the cross-sectional studies assessing the relationship with renal function by MVA, and 3/4 (75 %) assessing exercise capacity, found poorer outcomes associated with higher baseline GDF-15 concentrations. This SLR suggests GDF-15 is an independent predictor of mortality and other adverse but nonfatal outcomes in patients with HF. A better understanding of the prognostic role of GDF-15 in HF could improve clinical risk prediction models and potentially help optimize treatment regimens.

SUBMITTER: Javaheri A

PROVIDER: S-EPMC11369438 | biostudies-literature | 2024 Aug

REPOSITORIES: biostudies-literature

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Publications

Association between growth differentiation factor-15 and adverse outcomes among patients with heart failure: A systematic literature review.

Javaheri Ali A Ozcan Mualla M Moubarak Lauren L Smoyer Karen E KE Rossulek Michelle I MI Revkin James H JH Groarke John D JD Tarasenko Lisa C LC Kosiborod Mikhail N MN

Heliyon 20240808 16

Growth differentiation factor-15 (GDF-15) is an emerging biomarker in several conditions. This SLR, conducted following PRISMA guidelines, examined the association between GDF-15 concentration and range of adverse outcomes in patients with heart failure (HF). Publications were identified from Embase® and Medline® bibliographic databases between January 1, 2014, and August 23, 2022 (congress abstracts: January 1, 2020, to August 23, 2022). Sixty-three publications met the eligibility criteria (55 ...[more]

PMID: 39229539

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Project description:AimsHeart failure with preserved ejection fraction (HFpEF) continues to be an increasingly common health problem associated with a high mortality rate. Elevated levels of Growth differentiation factor-15 (GDF15) and N-terminal pro-brain natriuretic peptide (NT-proBNP) are reportedly associated with poor clinical outcomes in a broad range of cardiovascular diseases. The aim of the present study was to examine the effect of the combined assessment of these markers on clinical outcomes in patients with HFpEF.MethodsThis study is the prospective observational study. We measured the serum levels of GDF15 and NT-proBNP in 643 patients (mean age 73 ± 12, 42% females). All patients were prospectively followed up for a median period of 1998 days. Total 132 HF-related events and 88 all-cause deaths occurred during the follow-up period.ResultsMultivariate Cox proportional hazards regression analysis demonstrated that both serum GDF15 and NT-proBNP levels were independently associated with HF-related events after adjustment for confounding risk factors (GDF15: hazard ratio, 1.72; 95% confidence interval, 1.35-2.19; P < 0.0001 and NT-proBNP: hazard ratio, 1.63; 95% confidence interval, 1.25-2.13; P = 0.0003). Serum GDF15 levels improved the prediction capacity for HF-related events (0.7405 vs. 0.7190; P = 0.0422), with a significant net reclassification index (0.2724) and integrated discrimination improvement (0.0246). The C indices of GDF15 for HF-related events and all-cause deaths were significantly larger than those of NT-proBNP in men (HF-related events: 0.7389 vs. 0.6721; P = 0.0393, and all-cause deaths: 0.6922 vs.0.6109; P = 0.0262) but not in women. The combination of GDF15 and NT-proBNP levels stratified patients with HFpEF, identifying those at a high risk for HF-related events and all-cause deaths.ConclusionsSerum GDF15 could be an additional prognostic information to NT-proBNP in patients with HFpEF. The prognostic abilities of serum GDF15 and NT-proBNP differed according to sex. These markers were the feasible markers for patients with HFpEF, identifying those at a high risk for HF-related events and all-cause deaths.

Dataset Information

Association between growth differentiation factor-15 and adverse outcomes among patients with heart failure: A systematic literature review.

Publications

Association between growth differentiation factor-15 and adverse outcomes among patients with heart failure: A systematic literature review.

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