Association between growth differentiation factor-15 and adverse outcomes among patients with heart failure: A systematic literature review

• Published in: Heliyon Vol. 10; no. 16; p. e35916
• Main Authors: Javaheri, Ali, Ozcan, Mualla, Moubarak, Lauren, Smoyer, Karen E., Rossulek, Michelle I., Revkin, James H., Groarke, John D., Tarasenko, Lisa C., Kosiborod, Mikhail N.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 30.08.2024; Elsevier
• Subjects: biomarkers; exercise; Exercise capacity; heart failure; Hospitalization; Mortality; prediction; Renal function; risk; Hospitalization; Renal function; Exercise capacity; Mortality
• ISSN: 2405-8440; 2405-8440
• DOI: 10.1016/j.heliyon.2024.e35916

Growth differentiation factor-15 (GDF-15) is an emerging biomarker in several conditions. This SLR, conducted following PRISMA guidelines, examined the association between GDF-15 concentration and range of adverse outcomes in patients with heart failure (HF). Publications were identified from Embase® and Medline® bibliographic databases between January 1, 2014, and August 23, 2022 (congress abstracts: January 1, 2020, to August 23, 2022). Sixty-three publications met the eligibility criteria (55 manuscripts and 8 abstracts; 45 observational studies and 18 post hoc analyses of randomized controlled trials [RCTs]). Of the 19 outcomes identified, the most frequently reported longitudinal outcomes were mortality (n = 32 studies; all-cause [n = 27] or cardiovascular-related [n = 6]), composite outcomes (n = 28; most commonly mortality ± hospitalization/rehospitalization [n = 19]), and hospitalization/re-hospitalization (n = 11). The most common cross-sectional outcome was renal function (n = 22). Among longitudinal studies assessing independent relationships with outcomes using multivariate analyses (MVA), a significant increase in risk associated with higher baseline GDF-15 concentration was found in 22/24 (92 %) studies assessing all-cause mortality, 4/5 (80 %) assessing cardiovascular-related mortality, 13/19 (68 %) assessing composite outcomes, and 4/8 (50 %) assessing hospitalization/rehospitalization. All (7/7; 100 %) of the cross-sectional studies assessing the relationship with renal function by MVA, and 3/4 (75 %) assessing exercise capacity, found poorer outcomes associated with higher baseline GDF-15 concentrations. This SLR suggests GDF-15 is an independent predictor of mortality and other adverse but nonfatal outcomes in patients with HF. A better understanding of the prognostic role of GDF-15 in HF could improve clinical risk prediction models and potentially help optimize treatment regimens. •This SLR examined the association between GDF-15 and 19 HF-related outcomes.•63 studies (published 2014–2023) were included, several utilizing multivariate analyses.•45 were observational studies and 18 were post hoc analyses of RCTs.•Findings suggest higher GDF-15 is an independent predictor of adverse outcomes.