Growth differentiation factor–15 predicts the prognoses of patients with acute coronary syndrome: a meta-analysis

Abstract

BackgroundRecent studies have shown Growth differentiation factor–15 (GDF-15) that is a member of the transforming growth factor β (TGF-β) superfamily might be a potential predictive cytokine for the prognosis of Acute coronary syndrome (ACS). However, there are discrepancies in these studies.MethodsPublication searches of the PubMed/Medline and EMBASE databases were performed without any time or ethnicity restrictions. The inclusion and exclusion criteria, when clear, were addressed. Random effects models were used for all analyses. Publication bias was tested using funnel plots and the Egger test.ResultsWe identified eight eligible studies that provided mortality data. Five of these studies provided recurrent myocardial infarction (MI) data. The maximal duration of follow-up ranged from 6 months to 6 years. A significant association was found between the patients with the highest and lowest GDF-15 levels (overall analyses) in terms of mortality (p < 0.00001; RR = 6.08; 95 % CI = 4.79–7.71) and recurrent MI (p < 0.00001; RR = 1.76; 95 % CI = 1.49–2.07). We also found significant associations between the subgroup analyses stratified by ACS types, cutoff points and follow-up durations (p < 0.001). The combined hazard ratio was high for GDF-15 to ACS (HR = 1.656, 95 % CI = 1.467–1.871).ConclusionHigh plasma GDF-15 levels are associated with an increased risk of mortality and recurrent MI in patients with ACS.Electronic supplementary materialThe online version of this article (doi:10.1186/s12872-016-0250-2) contains supplementary material, which is available to authorized users.

Growth differentiation factor‐15 and the risk of cardiovascular diseases and all‐cause mortality: A meta‐analysis of prospective studies

“…Two studies were conducted on meta‐analysis of the relationship between GDF‐15 and the different prognosis of acute coronary syndromes and heart failure separately. One of them, GDF‐15 is classified as a categorical variable for statistical analysis, and the other is as a continuous variable . In our meta‐analysis, 31 studies were included for the further integration analysis comprehensively.…”

The association between serum growth differentiation factor 15 levels and lower extremity atherosclerotic disease is independent of body mass index in type 2 diabetes

“…The results from previous studies have shown that increased circulating GDF15 levels were closely associated with the development and progression of various cardiovascular diseases (including myocardial ischaemia/reperfusion, heart failure, atherosclerosis, and acute coronary syndrome), and were shown to be a strong and independent predictor of mortality and disease progression in patients with atherosclerosis and coronary artery disease [5][6][7][8][9][10][31][32][33][34][35][36]. In diabetic patients, higher levels of lipids and chronic inflammation may directly damage the cardiovascular system [37].…”

“…However, the expression and secretion of GDF15 can be strongly induced in the case of cardiovascular injury, such as pressure overload, myocardial infarction, heart failure, and atherosclerosis [4]. In recent years, a series of clinical studies [5][6][7][8][9][10] have reported that high circulating GDF15 levels are an independent predictive factor for several cardiovascular diseases in patients with atherosclerosis and acute coronary syndrome, and that investigating the levels of GDF15 could improve risk prediction beyond traditional risk factors and biochemical indicators.…”

The Biomarkers for Acute Myocardial Infarction and Heart Failure

“…GDF-15 expression is dramatically upregulated in cardiovascular disease, and the incidence of cardiovascular events is positively correlated with the concentration of GDF-15 [153,154], suggesting its potential value as a disease biomarker. Meta-analysis shows that high levels of GDF-15 may increase the risk of mortality in patients with cardiovascular diseases [155,156]. GDF-15 is an independent predictor of all-cause mortality in ACS patients, adding incremental value to traditional risk factors and to NT-proBNP and C-reactive protein levels [157,158].…”