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Growth differentiation factor-15 and routine laboratory parameters are associated with one-year mortality in patients
Wioletta Szczurek-Wasilewicz1, Oliwia Warmusz2, Michał Skrzypek3
12nd Ward of Cardiology and Angiology, Silesian Centre for Heart Diseases, Zabrze, Poland. wiolettaszczurek@interia.pl.
Insights
Higher levels of Growth Differentiation Factor-15 (GDF-15) and other biomarkers are linked to increased one-year mortality in end-stage heart failure patients. This finding highlights GDF-15 as a significant predictor of survival in advanced heart failure.
Area of Science:
- Cardiology
- Biomarkers
- Prognostics
Background:
- Growth Differentiation Factor-15 (GDF-15) influences inflammation, tissue repair, and cardiac remodeling, key factors in heart failure (HF).
- GDF-15 integrates signals from various disease pathways contributing to multiorgan dysfunction in advanced HF.
Purpose of the Study:
- To identify factors associated with one-year mortality in end-stage heart failure (HF) patients.
- To specifically evaluate the role of GDF-15 as a predictor of mortality in this population.
Main Methods:
- Prospective analysis of 315 hospitalized patients with end-stage HF undergoing heart transplantation evaluation (2018-2022).
- Serum GDF-15 concentrations measured via ELISA, alongside routine laboratory parameters.
- One-year all-cause mortality served as the primary endpoint.
Main Results:
- Higher serum concentrations of GDF-15, high-sensitivity C-reactive protein, fibrinogen, bilirubin, N-terminal pro-B-type natriuretic peptide, and gamma-glutamyl transpeptidase were independently associated with increased one-year mortality.
- GDF-15 showed a significant hazard ratio (HR) of 1.119 (P <0.001) for mortality.
Conclusions:
- Elevated GDF-15 levels are a significant independent predictor of worse survival in end-stage HF.
- Several other biomarkers, including hs-CRP, fibrinogen, bilirubin, NT-proBNP, and GGT, also correlate with poor prognosis in advanced HF.
Background:
Growth differentiation factor-15 (GDF-15) is a hormone that regulates inflammatory responses, tissue repair, and cardiac remodeling, the three key processes underlying the development and progression of heart failure (HF). Furthermore, GDF-15 integrates information from cardiac and extracardiac disease pathways that are linked to multiorgan dysfunction in advanced stages of HF.
Aim:
This study aimed to determine which factors are associated with one-year mortality in patients with end-stage HF, with particular emphasis on GDF-15.
Methods:
We prospectively analyzed 315 consecutive hospitalized patients with end-stage HF who underwent heart transplantation evaluation between 2018 and 2022. The endpoint was all-cause mortality during one-year follow-up. We measured routine laboratory parameters and the serum GDF-15 concentration using a sandwich enzyme-linked immunosorbent assay (ELISA) (SunRedBio Technology Co, Ltd, Shanghai, China).
Results:
The median age of the patients was 57 (50-62) years. During follow-up, 97 patients died. Higher serum concentrations of GDF-15 (hazard ratio [HR], 1.119; 95% CI, 1.095-1.144; P <0.001), high-sensitivity C-reactive protein (HR, 1.140; 95% CI, 1.037-1.253; P = 0.006), fibrinogen (HR, 1.003; 95% CI, 1.001-1.005; P = 0.003), bilirubin (HR, 1.055; 95% CI, 1.027-1.084; P <0.001), N-terminal pro-B-type natriuretic peptide (HR, 1.342; 95% CI, 1.206-1.493; P <0.001), and gamma-glutamyl transpeptidase (HR, 1.007; 95% CI, 1.002-1.012; P = 0.003) were independently associated with one-year mortality.
Conclusions:
Higher GDF-15, high-sensitivity C-reactive protein, fibrinogen, bilirubin, gamma-glutamyl transpeptidase, and N-terminal pro-B-type natriuretic peptide concentrations were independently associated with worse survival in patients with end-stage HF.
