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Published on: June 10, 2025
Prognostic value of growth differentiation factor-15 in Chinese patients with heart failure: A prospective
Hua Wang, Qingyong Chen, Yingying Li
1Beijing Hospital, Peking University West China Hospital, Sichuan University. yangjiefu2014@sina.com.
Insights
Growth differentiation factor-15 (GDF-15) is a significant predictor of mortality in Chinese heart failure (HF) patients. Higher GDF-15 levels indicate increased risk, aiding in patient stratification and prognosis.
Area of Science:
- Cardiology
- Biomarkers
- Clinical Research
Background:
- Growth differentiation factor-15 (GDF-15) is linked to heart remodeling, oxidative stress, and inflammation.
- GDF-15 is used to stratify heart failure (HF) patients, but its prognostic value in Chinese populations is unclear.
Purpose of the Study:
- To investigate the prognostic value of GDF-15 in Chinese patients with heart failure.
- To determine if GDF-15 can predict mortality and major adverse cardiac events (MACE) in this demographic.
Main Methods:
- 272 consecutive Chinese HF patients in Beijing Hospital were enrolled.
- GDF-15 levels were measured on admission using ELISA.
- All-cause mortality and HF readmission were tracked for a median of 558 days.
Main Results:
- 19.5% of patients died, and 37.9% experienced MACE (all-cause mortality or HF readmission).
- Elevated GDF-15 levels (third tertile) significantly correlated with increased all-cause mortality and MACE.
- GDF-15 remained an independent predictor of all-cause death after adjusting for clinical variables.
Conclusions:
- Plasma GDF-15 is an independent predictor of all-cause mortality in Chinese HF patients.
- GDF-15 shows potential for stratifying risk and improving prognostication in this patient group.
Background:
Growth differentiation factor-15 (GDF-15), a biomarker associated with remodeling, oxidative stress and inflammation, has been used to stratify heart failure (HF) patients. However, its prognostic value in Chinese HF patients is still unknown.
Methods:
GDF-15 levels were examined on admission in 272 consecutive HF patients in Beijing Hospital (a Chinese tertiary medical center) by a commercial enzyme-linked immunosorbent assay. We recorded the incidence of all-cause mortality and/or readmission for HF during a median follow-up period of 558 days. Patients were stratified according to the tertiles of GDF-15.
Results:
Fifty-three (19.5%) patients died and 103 (37.9%) patients had major adverse cardiac events (MACE) which included the composite outcome of all-cause mortality or readmission for HF at the end of follow-up. Kaplan-Meier survival curves showed that the third tertile of GDF-15 was associated with increased rate of all-cause mortality (compared with the first and second tertiles, log rank p = 0.001 and 0.001, respectively) or MACE (compared with the first and second tertiles, log rank p = 0.002 and p < 0.001, respectively). In addition, multivariate Cox regression model showed that the highest tertile of GDF-15 was independently associated with increased risk of all-cause death (hazard ratio = 5.95, 95% confidence interval 1.88-18.78, p = 0.002) compared with the lowest tertile after adjustment for related clinical variables such as age, renal function or N-terminal pro-B-type natriuretic peptide.
Conclusions:
Plasma GDF-15 is an independent predictor of all-cause mortality in Chinese patients with HF. It may potentially be used to stratify and prognosticate HF patients.
