GDF-15: A novel biomarker of heart failure predicts 30-day all-cause mortality and 30-day HF rehospitalization in patients with acute heart failure syndrome

Abstract

Abstract Background: Growth Differentiation Factor-15 (GDF-15) is a distant member of the transforming growth factor-β. The increased expression of GDF-15 has been observed during heart failure and is associated with worse outcomes. However, the relationship between GDF-15 and acute heart failure (AHF) is not well understood with limited evidence among Thai patients. Purpose: To study the association between cumulative level and biomarker at the time of admission and discharge in patients with AHF and their association with 30-day all-cause mortality and heart failure rehospitalization Methods: This is a prospective, single-center study of patients admitted for AHF. GDF-15, high-sensitivity troponin (hsTrop) and NT-proBNP were measured at the time of admission and discharge. Outcomes, including 30-day all-cause mortality and rehospitalization, were collected. Logistic regression analysis was used to evaluate outcomes. Results: A total of 84 patients were enrolled (mean age of 69 years, 52% females). The GDF-15 level significantly decreased during admission (at the time of admission 9,118 pg/mL, at the time of discharge 7,107 pg/mL, mean differences 1528; p = 0.006). The 30-day all-cause mortality was 6%. The 30-day rehospitalization occurred in 22 (26.1%) patients. Univariate analysis showed that the admission GDF-15 level, but not hsTrop or NT-proBNP, was associated with 30-days all-cause mortality (p = 0.029) and multivariate analysis showed a reduction in GDF-15 level from admission to discharge was associated with lower 30-days rehospitalization (p = 0.023). Conclusion: The GDF-15 levels were elevated during acute HF and improved by the time of discharge. This novel biomarker may offer additional value in predicting outcomes in acute HF.