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Review
. 2021 Dec 6:47:1-7.
doi: 10.1016/j.athplu.2021.11.003. eCollection 2022 Jan.

Association of growth differentiation factor-15 level with adverse outcomes in patients with stable coronary artery disease: A meta-analysis

Tingjian Li  1 , Youjin Chen  1 , Tingting Ye  1 , Lin Zheng  1 , Luo Chen  1 , Yuncao Fan  1 , Bin Lin  1
Affiliations
Review

Association of growth differentiation factor-15 level with adverse outcomes in patients with stable coronary artery disease: A meta-analysis

Tingjian Li et al. Atheroscler Plus. .

Abstract

Background and aims: Studies on the association between growth-differentiation factor-15 (GDF-15) level and adverse outcomes have yielded conflicting results in patients with stable coronary artery disease (CAD). This meta-analysis aimed to evaluate the association of baseline GDF-15 level with adverse outcomes in stable CAD patients.

Methods: Two authors independently searched PubMed and Embase databases from inception to May 31, 2021 for available studies that investigated the association of baseline GDF-15 level with all-cause mortality, cardiovascular mortality, or major adverse cardiovascular events (MACEs) in stable CAD patients. Pooled multivariable adjusted hazard ratio (HR) with 95% confidence interval (CI) was calculated for the highest vs. the lowest GDF-15 level.

Results: Seven studies that involved 28,765 stable CAD patients were identified and analyzed. The meta-analysis showed that the highest GDF-15 level was associated with higher risk of MACEs (HR 1.42; 95% CI 1.29-1.57; p < 0.001), cardiovascular mortality (HR 1.64: 95% CI 1.25-2.14; p < 0.001), and all-cause mortality (HR 2.01; 95% CI 1.67-2.42; p < 0.001) when compared the lowest GDF-15 level. Moreover, the values of GDF-15 level in predicting MACEs were consistently observed in each named subgroup.

Conclusions: Elevated blood GDF-15 level is an independent predictor of MACEs, cardiovascular mortality, and all-cause mortality in stable CAD patients. The baseline GDF-15 level may play an important role in the risk stratification of stable CAD patients.

Keywords: Growth-differentiation factor-15; Major adverse cardiovascular events; Meta-analysis; Mortality; Stable coronary artery disease.

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Conflict of interest statement

The authors declare that there are no conflicts of interest.

Figures

Image 1
Graphical abstract
Fig. 1
Fig. 1
Flow chart showing the study selection process.
Fig. 2
Fig. 2
Forest plots showing the pooled HR and 95% CI of major adverse cardiovascular events for the highest vs the lowest growth differentiation factor 15 level in a fixed-effect model. The sizes of the squares are proportional to the weights of the individual studies. The diamond symbol represents the pooled risk estimates. Horizontal lines show the ranges of 95% CI.
Fig. 3
Fig. 3
Forest plots showing the pooled HR and 95% CI of cardiovascular mortality for the highest vs the lowest growth differentiation factor 15 level in a fixed-effect model. The sizes of the squares are proportional to the weights of the individual studies. The diamond symbol represents the pooled risk estimates. Horizontal lines show the ranges of 95% CI.
Fig. 4
Fig. 4
Forest plots showing the pooled HR and 95% CI of all-cause mortality for the highest vs the lowest growth differentiation factor 15 level in a fixed-effect model. The sizes of the squares are proportional to the weights of the individual studies. The diamond symbol represents the pooled risk estimates. Horizontal lines show the ranges of 95% CI.
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