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Growth-differentiation factor 15 as a predictor of mortality in patients with heart failure: a meta-analysis

Zeng, Xiaocong; Li, Lang; Wen, Hong; Bi, Qi

Journal of Cardiovascular Medicine: February 2017 - Volume 18 - Issue 2 - p 53–59
doi: 10.2459/JCM.0000000000000412
Focused issue on heart failure and aortic valve disease review
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Aims Measurement of the biomarker growth-differentiation factor 15 (GDF-15) in patients with heart failure may help in risk stratification. We assessed the relationship between GDF-15 and mortality in patients with heart failure by conducting a meta-analysis.

Methods PubMed, Embase, ISI Web of Science, SCOPUS, and Cochrane Library databases were searched for studies that reported data on the baseline GDF-15 levels and all-cause or cardiovascular mortality. Pooled hazard ratios for mortality were calculated and presented with 95% confidence intervals (CIs). Potential sources of heterogeneity were assessed by meta-regression, subgroup, and sensitivity analyses.

Results Eight studies with a total of 4126 heart failure patients were included. Pooled results showed that overexpression of GDF-15 was associated with poor survival in heart failure patients (log unit GDF-15: hazard ratio = 1.86, 95% CI = 1.37–2.52). Subgroup analyses revealed similar results. However, there was evidence of heterogeneity and publication bias. The association disappeared after correction using the trim-and-fill method (log unit GDF-15: hazard ratio 1.07, 95% CI 0.80–1.42).

Conclusion The results of this meta-analysis indicate an association of elevated GDF-15 levels with increased risk of mortality in patients with heart failure. However, the results should be interpreted with caution due to substantial heterogeneity and publication bias among the studies included in the meta-analysis.

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Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People's Republic of China

Correspondence to Lang Li, PhD, Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi, People's Republic of China Tel: +86 771 5331171; e-mail: aban829@163.com

Received 14 December, 2015

Revised 17 May, 2016

Accepted 25 May, 2016

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© 2017 Italian Federation of Cardiology. All rights reserved.