Heart failure & cardiomyopathies
Prognostic Value of Growth Differentiation Factor-15 in Heart Failure Among Whole Ejection Fraction Phenotypes
Authors' conclusion
GDF-15 is identified as an independent risk factor for adverse outcomes in HF patients across the entire EF spectrum in the context of CHD.
Study context
- Population
- Heart failure (HF) patients with coronary heart disease (CHD) across ejection fraction (EF) phenotypes
- Participants
- 823 patients
- Exposure
- GDF-15 levels and adverse outcomes across EF phenotypes; MAGGIC model with vs without GDF-15
- HFrEFn = 230
- HFmrEFn = 271
- HFpEFn = 322
- Outcome
- All-cause mortality and HF rehospitalization
- Follow-up
- 9.4 year
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
Association of elevated GDF-15 with outcomes (multivariate Cox)
Hazard ratio (95% CI)P value
Elevated GDF-15all-cause mortality
1.36(1.20–1.54)
P < 0.001Elevated GDF-15HF rehospitalization
1.75(1.57–1.95)
P < 0.001High GDF-15all-cause death, categorical GDF-15
1.73(1.40–2.14)
P < 0.001High GDF-15HF rehospitalization, categorical GDF-15
3.37(2.73–4.15)
P < 0.001- Deaths
- 425
- Rehospitalized due to HF
- 484
Observational data: associations, not effects.
Further findings
| Outcome | Δ C-index (95% CI) | |
|---|---|---|
| Incremental prognostic value of adding GDF-15 to MAGGIC model, all HF patientsMAGGIC + GDF-15vs MAGGICParticularly in the HFpEF subgroup | 0.021 (0.002–0.041) | |
| Incremental prognostic value of adding GDF-15 to MAGGIC model, HF rehospitalizationMAGGIC + GDF-15vs MAGGICParticularly in the HFpEF subgroup | 0.034 (0.005–0.063) | |
| −0.0500.050.1Difference (linear scale) |
| Outcome | Estimate |
|---|---|
| Incremental prognostic value of adding GDF-15 to MAGGIC model, all HF patientsMAGGIC + GDF-15 vs MAGGIC · particularly in the HFpEF subgroup | IDI 0.011 (95% CI 0.001–0.025) |
| Incremental prognostic value of adding GDF-15 to MAGGIC model, all HF patientsMAGGIC + GDF-15 vs MAGGIC · particularly in the HFpEF subgroup | continuous NRI 0.489 (95% CI 0.174–0.629) |
| Incremental prognostic value of adding GDF-15 to MAGGIC model, HF rehospitalizationMAGGIC + GDF-15 vs MAGGIC · particularly in the HFpEF subgroup | IDI 0.021 (95% CI 0.007–0.032) |
| Incremental prognostic value of adding GDF-15 to MAGGIC model, HF rehospitalizationMAGGIC + GDF-15 vs MAGGIC · particularly in the HFpEF subgroup | continuous NRI 0.307 (95% CI 0.147–0.548) |
GDF-15 concentration and MAGGIC score by EF phenotype
- Higher GDF-15 concentration in HFpEF vs HFrEF and HFmrEF
- P = 0.002
- Higher MAGGIC risk score in HFpEF vs HFrEF and HFmrEF
- P < 0.001
Original publication
Prognostic Value of Growth Differentiation Factor-15 in Heart Failure Among Whole Ejection Fraction Phenotypes. ESC Heart Fail. Published 19 April 2024. doi:10.
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