Vol 25, No 2 (2018)
Original articles — Clinical cardiology
Published online: 2017-06-12

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Prognostic value of growth differentiation factor-15 in Chinese patients with heart failure: A prospective observational study

Hua Wang, Qingyong Chen, Yingying Li, Xianchao Jing, Jiefu Yang
Pubmed: 28612904
Cardiol J 2018;25(2):245-253.


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.

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