Dynamics of growth differentiation factor 15 in acute heart failure

• Type: Article in International Scientific Journal
• Date: 2021

Authors

Lourenco, P (Author) FMUP; Cunha, FM (Author) Other; Ferreira Coimbra, J (Author) Other; Barroso, I (Author) Other; guimaraes, jt (Author) FMUP; Bettencourt P (Author) FMUP

Journal

Title: ESC heart failure

Vol. 8

Pages: 2527-2534

Publisher: The Heart Failure Association of the European Society of Cardiology

Indexing

ISI Web of Knowledge - 5 Citations

Scopus - 3 Citations

Other information

Authenticus ID: P-00T-VZS

DOI: 10.1002/ehf2.13377

Abstract (EN): Aims Risk stratification in acute heart failure (HF) patients can help to decide therapies and time for discharge. The potential of growth differentiation factor 15 (GDF-15) in HF has been previously shown. We aimed to study the importance of GDF-15-level variations in acute HF patients. Methods and results We retrospectively evaluated a cohort of patients hospitalized due to acute HF. GDF-15 was measured both at admission and on the discharge day. Patients were followed-up during a 3 year period. The endpoint under analysis was all-cause mortality. GDF-15 variation is equal to [(admission GDF-15 - discharge GDF-15)/admission GDF-15] x 100. Variation was categorized in levels of increase or decrease of GDF-15. Patients were cross-classified according to admission and discharge GDF-15 cut-off points. A Cox regression analysis was used to assess the prognostic impact of GDF-15 variation and the impact of both admission and discharge GDF-15 according to the cross-classification. We studied a group of 249 patients with high co-morbidity burden. Eighty-one patients died at 1 year and 147 within 3 years. There was a modest decrease in GDF-15 during hospitalization from a median value of 4087 to 3671 ng/mL (P = 0.02). No association existed between GDF-15 variation and mortality. In multivariate analysis, patients with admission GDF-15 >= 3500 ng/mL and discharge GDF-15 >= 3000 ng/mL had a significantly higher 1 year death risk when compared with the remaining-hazard ratio = 2.59 (95% confidence interval: 1.41-4.76)-and a 3 year 1.76 (95% confidence interval: 1.08-2.87) higher death risk compared with those with both values below the cut-off. Conclusions Growth differentiation factor 15 decreased during an acute HF hospitalization, but its variation had no prognostic implications. The knowledge of both admission and discharge GDF-15 added meaningful information to patients' risk stratification.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 8