Growth differentiation factor 15: A biomarker to guide empagliflozin treatment in acute myocardial infarction?
- PMID: 40088956
- DOI: 10.1016/j.ijcard.2025.133167
Growth differentiation factor 15: A biomarker to guide empagliflozin treatment in acute myocardial infarction?
Abstract
Introduction: Growth Differentiation Factor-15 (GDF-15) has been proven useful as a prognostic biomarker after an acute myocardial infarction (MI) and might be used to refine the selection of high-risk patients that could benefit from empagliflozin therapy. This study aims to compare the prognostic performance of GDF-15 with the inclusion criteria of the EMPACT-MI trial to identify patients at high risk of developing heart failure (HF) after an acute MI.
Methods and results: A cohort of 275 acute MI patients with GDF-15 concentration available and long-term follow-up was analyzed. Patients were classified into two categories, high risk (HRHF) or no high risk of development of HF (NHRHF), according to two models: 1) GDF-15: HRHF if >1800 ng/L and NHRHF if ≤1800 ng/L; and 2) EMPACT-MI criteria: HRHF if meeting the trial inclusion criteria. Cox regression and ROC curve analyses were used to evaluate the prognostic performance of both models. GDF-15 showed a stronger association with the composite endpoint of all-cause death or first hospitalization for HF (HR 10.7, 95 % CI 5.5-21.0) compared to EMPACT-MI inclusion criteria (HR 3.9, 95 % CI 2.2-6.8). Additionally, GDF-15 had superior discriminative ability (c-index 0.790 vs 0.629, p = 0.004). Similar results were obtained for HF first hospitalization.
Conclusions: GDF-15 may have a better discriminative ability than the inclusion criteria of the EMPACT-MI trial to identify those patients at higher risk of death and HF after an acute MI, who could potentially benefit from empagliflozin therapy.
Keywords: Acute myocardial infarction; Empagliflozin; GDF-15; Heart failure.
Copyright © 2025 Elsevier B.V. All rights reserved.
Conflict of interest statement
Declaration of competing interest Óscar M. Peiró reports honoraria for lectures from Amgen, AstraZeneca, Boehringer Ingelheim, Daiichi Sankyo, Ferrer, NovoNordisk, Sanofi and Viatris Pharmaceutical. José Luis Ferreiro reports a) honoraria for lectures from Eli Lilly Co, Daiichi Sankyo, Inc., AstraZeneca, Pfizer, Abbott, Boehringer Ingelheim, Bristol-Myers Squibb, Rovi, Terumo and Ferrer; b) consulting fees from AstraZeneca, Eli Lilly Co., Ferrer, Boston Scientific, Pfizer, Boehringer Ingelheim, Daiichi Sankyo,Inc., Bristol-Myers Squibb and Biotronik; c) research grants from AstraZeneca.
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