open access

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
DOI: 10.5603/CJ.a2017.0068
·
Pubmed: 28612904
·
Cardiol J 2018;25(2):245-253.

open access

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

Abstract

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.

Abstract

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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Keywords

growth differentiation factor-15, heart failure, remodeling, biomarker, prognosis

About this article
Title

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

Journal

Cardiology Journal

Issue

Vol 25, No 2 (2018)

Pages

245-253

Published online

2017-06-12

DOI

10.5603/CJ.a2017.0068

Pubmed

28612904

Bibliographic record

Cardiol J 2018;25(2):245-253.

Keywords

growth differentiation factor-15
heart failure
remodeling
biomarker
prognosis

Authors

Hua Wang
Qingyong Chen
Yingying Li
Xianchao Jing
Jiefu Yang

References (27)
  1. McMurray JJV, Adamopoulos S, Anker SD, et al. ESC Committee for Practice Guidelines. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2012; 33(14): 1787–1847.
  2. Yancy CW, Jessup M, Bozkurt B, et al. 2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2013; 128(16): e240–e327.
  3. Zhou J, Cui X, Ge J. [The epidemiological profile of heart failure patients in China]. Zhonghua Xin Xue Guan Bing Za Zhi. 2015; 43(12): 1018–1021.
  4. Rose EA, Gelijns AC, Moskowitz AJ, et al. Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart Failure (REMATCH) Study Group. Long-term use of a left ventricular assist device for end-stage heart failure. N Engl J Med. 2001; 345(20): 1435–1443.
  5. Tsutamoto T, Wada A, Maeda K, et al. Attenuation of compensation of endogenous cardiac natriuretic peptide system in chronic heart failure: prognostic role of plasma brain natriuretic peptide concentration in patients with chronic symptomatic left ventricular dysfunction. Circulation. 1997; 96(2): 509–516.
  6. Anker SD, Doehner W, Rauchhaus M, et al. Uric acid and survival in chronic heart failure: validation and application in metabolic, functional, and hemodynamic staging. Circulation. 2003; 107(15): 1991–1997.
  7. AbouEzzeddine OF, Haines P, Stevens S, et al. Galectin-3 in heart failure with preserved ejection fraction. A RELAX trial substudy (Phosphodiesterase-5 Inhibition to Improve Clinical Status and Exercise Capacity in Diastolic Heart Failure). JACC Heart Fail. 2015; 3(3): 245–252.
  8. Gaggin HK, Januzzi JL. Biomarkers and diagnostics in heart failure. Biochim Biophys Acta. 2013; 1832(12): 2442–2450.
  9. Domínguez-Rodríguez A, Avanzas P, González-González J, et al. Growth Differentiation Factor 15, a New Prognostic Marker in Diabetic Cardiomyopathy. Rev Esp Cardiol (Engl Ed). 2016; 69(1): 81–83.
  10. Bootcov MR, Bauskin AR, Valenzuela SM, et al. MIC-1, a novel macrophage inhibitory cytokine, is a divergent member of the TGF-beta superfamily. Proc Natl Acad Sci U S A. 1997; 94(21): 11514–11519.
  11. Braunwald E. The war against heart failure: the Lancet lecture. Lancet. 2015; 385(9970): 812–824.
  12. Wollert KC, Kempf T. Growth differentiation factor 15 in heart failure: an update. Curr Heart Fail Rep. 2012; 9(4): 337–345.
  13. Kempf T, Björklund E, Olofsson S, et al. Growth-differentiation factor-15 improves risk stratification in ST-segment elevation myocardial infarction. Eur Heart J. 2007; 28(23): 2858–2865.
  14. Khan SQ, Ng K, Dhillon O, et al. Growth differentiation factor-15 as a prognostic marker in patients with acute myocardial infarction. Eur Heart J. 2009; 30(9): 1057–1065.
  15. Minamisawa M, Motoki H, Izawa A, et al. Comparison of Inflammatory Biomarkers in Outpatients With Prior Myocardial Infarction. Int Heart J. 2016; 57(1): 11–17.
  16. Wallentin L, Hijazi Z, Andersson U, et al. ARISTOTLE Investigators. Growth differentiation factor 15, a marker of oxidative stress and inflammation, for risk assessment in patients with atrial fibrillation: insights from the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE) trial. Circulation. 2014; 130(21): 1847–1858.
  17. Dominguez-Rodriguez A, Abreu-Gonzalez P, Avanzas P. Usefulness of growth differentiation factor-15 levels to predict diabetic cardiomyopathy in asymptomatic patients with type 2 diabetes mellitus. Am J Cardiol. 2014; 114(6): 890–894.
  18. Vasan RS, Levy D. Defining diastolic heart failure: a call for standardized diagnostic criteria. Circulation. 2000; 101(17): 2118–2121.
  19. Steinberg BA, Zhao X, Heidenreich PA, et al. Get With the Guidelines Scientific Advisory Committee and Investigators. Trends in patients hospitalized with heart failure and preserved left ventricular ejection fraction: prevalence, therapies, and outcomes. Circulation. 2012; 126(1): 65–75.
  20. Levey AS, Bosch JP, Lewis JB, et al. A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group. Ann Intern Med. 1999; 130(6): 461–470.
  21. Manzano-Fernández S, Januzzi JL, Boronat-Garcia M, et al. β-trace protein and cystatin C as predictors of long-term outcomes in patients with acute heart failure. J Am Coll Cardiol. 2011; 57(7): 849–858.
  22. Anand IS, Kempf T, Rector TS, et al. Serial measurement of growth-differentiation factor-15 in heart failure: relation to disease severity and prognosis in the Valsartan Heart Failure Trial. Circulation. 2010; 122(14): 1387–1395.
  23. Kempf T, von Haehling S, Peter T, et al. Prognostic utility of growth differentiation factor-15 in patients with chronic heart failure. J Am Coll Cardiol. 2007; 50(11): 1054–1060.
  24. Foley PWX, Stegemann B, Ng K, et al. Growth differentiation factor-15 predicts mortality and morbidity after cardiac resynchronization therapy. Eur Heart J. 2009; 30(22): 2749–2757.
  25. Stahrenberg R, Edelmann F, Mende M, et al. The novel biomarker growth differentiation factor 15 in heart failure with normal ejection fraction. Eur J Heart Fail. 2010; 12(12): 1309–1316.
  26. Nickel N, Jonigk D, Kempf T, et al. GDF-15 is abundantly expressed in plexiform lesions in patients with pulmonary arterial hypertension and affects proliferation and apoptosis of pulmonary endothelial cells. Respir Res. 2011; 12: 62.
  27. Ding Qi, Mracek T, Gonzalez-Muniesa P, et al. Identification of macrophage inhibitory cytokine-1 in adipose tissue and its secretion as an adipokine by human adipocytes. Endocrinology. 2009; 150(4): 1688–1696.

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