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Levels of Growth Differentiation Factor 15 and Early Mortality Risk Stratification in Cardiogenic Shock

Mari Hongisto1, Anu Kataja1, Tuukka Tarvasmäki2

  • 1Emergency Medicine, University of Helsinki and Department of Emergency Medicine and Services, Helsinki University Hospital, Helsinki, Finland.

Journal of Cardiac Failure
|July 17, 2019
PubMed

Insights

Growth Differentiation Factor 15 (GDF-15) is highly elevated in cardiogenic shock (CS) and predicts mortality. Early GDF-15 levels can distinguish survivors from non-survivors, improving risk stratification.

Area of Science:

  • Biochemistry
  • Cardiology
  • Biomarkers

Background:

  • Cardiogenic shock (CS) is a critical condition with high mortality.
  • Identifying reliable prognostic markers in CS is crucial for patient management.

Purpose of the Study:

  • To evaluate the levels, kinetics, and prognostic significance of Growth Differentiation Factor 15 (GDF-15) in patients with CS.
  • To assess the role of GDF-15 in predicting 90-day mortality and improving risk stratification in CS.

Main Methods:

  • Serial plasma samples from 177 CS patients were analyzed for GDF-15 levels over 120 hours.
  • Kinetics of GDF-15 were studied in relation to patient outcomes.
  • Association of GDF-15 levels with mortality and its incremental value to existing risk scores were assessed.

Main Results:

  • Elevated GDF-15 levels at 0 hours (median 9647 ng/L) were linked to acidosis, hyperlactatemia, renal dysfunction, and increased 90-day mortality (56% vs 28%).
  • Non-survivors consistently showed higher GDF-15 levels than survivors throughout the observation period.
  • A GDF-15 level >7000 ng/L at 12 hours independently predicted mortality and improved risk stratification when added to the CardShock score.

Conclusions:

  • GDF-15 is significantly elevated in CS patients, correlating with systemic hypoperfusion and organ dysfunction.
  • GDF-15 serves as an early and effective biomarker for discriminating between survivors and non-survivors in CS.
  • The early assessment of GDF-15 levels enhances prognostic accuracy in cardiogenic shock management.
Abstract

Keywords:
Cardiogenic shockbiomarkersgrowth differentiation factor 15 (GDF-15)prognosis

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