Diagnostic and prognostic implications of growth differentiation factor 15 in heart failure with preserved ejection fraction: a systematic review and meta-analysis.
Level 3 - non-randomized controlled study
Systematic review and meta-analysis of observational studies
PubMed 41180477 · doi:10.7717/peerj.20168
What was done
A systematic review and random-effects meta-analysis was conducted across three databases (PubMed, Scopus, ScienceDirect) through August 6, 2024 (PROSPERO CRD42024569609). Study quality was assessed with the Newcastle-Ottawa scale and leave-one-out sensitivity analyses were performed. The review analyzed 12 observational studies comprising 28,193 total individuals, including 5,696 patients with heart failure with preserved ejection fraction (HFpEF), to evaluate the diagnostic and prognostic performance of growth differentiation factor-15 (GDF-15).
What was found
GDF-15 levels were significantly higher in HFpEF patients than controls (pooled mean difference 647.60 pg/mL, 95% CI [148.43, 1,146.77]; p = 0.01). For diagnosis, GDF-15 demonstrated a pooled area under the curve (AUC) of 0.82 (95% CI [0.72, 0.91]). Prognostically, elevated GDF-15 was associated with increased risks of all-cause mortality (pooled HR 1.46, 95% CI [1.30, 1.62]; p < 0.01) and heart failure hospitalization (pooled HR 1.76, 95% CI [1.30, 2.38]; p < 0.01).
Why it matters
This meta-analysis indicates that circulating GDF-15 provides diagnostic accuracy and prognostic risk stratification for adverse clinical outcomes, including mortality and rehospitalization, in patients with HFpEF.
Limits
The review relies entirely on observational studies. Substantial heterogeneity was observed for mean difference estimates, and standardized clinical cutoffs were not established across the included assay platforms.
Cited by
- supports GDF15 is significantly elevated in heart failure and dilated cardiomyopathy and serves as a diagnostic/prognostic biomarker in cardiology.