Growth differentiation factor 15 and cardiovascular risk: individual patient meta-analysis

Area of Science:

• Cardiology
• Biomarkers
• Inflammation

Background:

• Growth differentiation factor 15 (GDF-15) is a stress-responsive cytokine implicated in cardiovascular (CV) events.
• Its prognostic value across diverse atherosclerotic cardiovascular disease (ASCVD) presentations is not well-defined.

Approach:

• An individual patient meta-analysis of 53,486 patients from eight trials was conducted.
• GDF-15 levels were analyzed continuously and by established cutpoints.
• Prognostic performance was evaluated for CV death, hospitalization for heart failure (HHF), major adverse cardiovascular events (MACE), myocardial infarction (MI), and stroke, stratified by ASCVD status (ACS, stabilized ACS, stable ASCVD).

Key Points:

• Higher GDF-15 concentrations were independently associated with increased rates of CV death/HHF and MACE (P < 0.001).
• GDF-15 consistently provided prognostic information for CV death and HHF across all ASCVD presentations.
• Prognostic value for MI and stroke was significant in stabilized ACS and stable ASCVD, but not in acute coronary syndrome (ACS).

Conclusions:

• GDF-15 consistently adds prognostic information for CV death and HHF across the ASCVD spectrum.
• GDF-15 provides additional prognostic information for MI and stroke beyond traditional risk factors and biomarkers, but not in the acute coronary syndrome setting.