Key result
A per 1 LnU increase in baseline GDF-15 concentration was associated with a 6% increased risk of all-cause mortality in patients with chronic heart failure (HR 1.06).
Why the study?
Previous studies reported increased circulating GDF-15 in CHF, suggesting potential prognostic significance, prompting an updated meta-analysis to verify the relationship between circulating GDF-15 levels and CHF prognosis.
Does elevated baseline GDF-15 predict all-cause mortality in patients with chronic heart failure?
Meta-Analysis (n=6,244)
Yes
Does elevated baseline GDF-15 predict all-cause mortality in patients with chronic heart failure?
Hazard Ratio: 1.06 (95% CI 1.03–1.1)
p-value: p=<0.001
Elevated circulating GDF-15 is a significant prognostic indicator for increased all-cause mortality in chronic heart failure, especially in patients with ischemic etiology.
May enhance CHF risk stratification; extends meta-analytic evidence but should not yet change practice.
Background: Previous studies had reported increased circulating concentrations of growth differentiation factor-15 (GDF-15) in chronic heart failure (CHF), suggesting the potential prognostic significance of GDF-15 in this setting. To verify the relationship between the circulating GDF-15 levels and prognosis of CHF patients, we conducted an updated evidence-based meta-analysis. Methods: A comprehensive literature retrieval of PubMed, EMBASE, and Cochrane library was performed to collect the qualified studies that analyzed the prognostic value of GDF-15 in CHF from the inception of these online databases to September 25, 2021. The hazard ratio (HR) calculated for logGDF-15 of all-cause death and the related 95% confidence interval (CI) in multivariate analysis were used to measure the effect size. Additionally, subgroup analyses stratified by characteristics of the study participants were conducted for incremental evidence of GDF-15 in CHF with different clinical status. Results: A total of ten eligible studies involving 6,244 CHF patients were finally taken into the quantitative analysis. Results in the random-effects model indicated that there was an increased risk of 6% in all-cause mortality with a per 1LnU increase in baseline GDF-15 concentration (HR: 1.06, 95% CI: 1.03–1.10, P < 0.001). In stratified analyses, the association of GDF-15 with risk of all-cause mortality was found among chronic ischemic HF patients (HR:1.75, 95%CI: 1.24–2.48, P = 0.002), while the association was not found among chronic nonischemic HF patients (HR:1.01, 95%CI: 1.00–1.02, P = 0.219). Conclusion: The elevated GDF-15 is associated with an increased risk of all-cause mortality in CHF, especially, among CHF patients with ischemic etiology. The circulating GDF-15 might be a prognostic indicator in CHF patients. Registration Number: https://www.crd.york.ac.uk/PROSPERO ; CRD42020210796.
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Luo et al. (2021) conducted a meta-analysis in Chronic Heart Failure (CHF) (n=6,244). Elevated baseline GDF-15 concentration vs. Lower GDF-15 concentration was evaluated on All-cause mortality (HR 1.06, 95% CI 1.03-1.10, p=<0.001). A per 1 LnU increase in baseline GDF-15 concentration was associated with a 6% increased risk of all-cause mortality in patients with chronic heart failure (HR 1.06).
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