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New Biomarkers in the Prognostic Assessment of Acute Heart Failure with Reduced Ejection Fraction: Beyond Natriuretic

Marcelino Cortés1,2, Jairo Lumpuy-Castillo3,4, Camila Sofía García-Talavera5

  • 1Cardiology Department, Fundación Jiménez Díaz University Hospital, 28040 Madrid, Spain.

International Journal of Molecular Sciences
|February 13, 2025
PubMed

Insights

New biomarkers Growth Differentiation Factor 15 (GDF-15) and soluble ST2 (sST2) show strong predictive power for mortality in acute heart failure patients. These markers offer improved prognostic insights beyond traditional natriuretic peptides.

Area of Science:

  • Cardiology
  • Biomarker Discovery
  • Prognostics

Background:

  • Natriuretic peptides are established heart failure (HF) prognostic markers.
  • The prognostic value of novel cardiovascular biomarkers in HF with reduced ejection fraction (HFrEF) remains unclear.
  • Acute decompensated heart failure (ADHF) requires accurate prognostic tools.

Purpose of the Study:

  • To evaluate the prognostic value of novel plasma biomarkers in patients with ADHF and HFrEF.
  • To compare the predictive power of GDF-15 and sST2 against established biomarkers like NT-proBNP.
  • To identify the strongest predictors of all-cause mortality in this patient cohort.

Main Methods:

  • Prospective, single-center study of 104 ADHF with HFrEF patients (July 2019 - March 2023).
  • Median follow-up of 23.5 months, recording all-cause mortality and HF readmissions.
  • Plasma levels of NT-proBNP, GDF-15, sST2, suPAR, and FGF-23 were measured. Cox regression analysis was performed.

Main Results:

  • GDF-15 and sST2 demonstrated significant association with increased all-cause mortality risk.
  • Estimated glomerular filtration rate (eGFR), GDF-15, and sST2 were the strongest independent predictors of mortality.
  • A predictive model combining eGFR and sST2 achieved the highest predictive accuracy (C-index 0.758).

Conclusions:

  • GDF-15 and sST2 exhibit superior predictive power for mortality in ADHF with HFrEF compared to natriuretic peptides.
  • These novel biomarkers provide valuable additional prognostic information for risk stratification.
  • Integrating GDF-15 and sST2 into clinical assessment may enhance prognostic accuracy for HFrEF patients.

Keywords:
GDF 15biomarkersprognosissST2systolic heart failure

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