Jia Xiaotong, Gao Junwei, Qi Zeyou, Ma Jun
Department of Anesthesiology, Beijing Anzhen Hospital, Capital Medical University, 100029 Beijing, China.
Rev Cardiovasc Med. 2025 Apr 16;26(4):28279. doi: 10.31083/RCM28279. eCollection 2025 Apr.
This systematic review and meta-analysis aimed to evaluate the predictive effect of Growth Differentiation Factor-15 (GDF-15) on adverse outcomes in patients undergoing cardiovascular interventions.
A comprehensive literature search was performed across PubMed, EMBASE, Cochrane Library, and Web of Science databases. The meta-analysis used hazard ratios (HR) and odds ratios (OR) to compare outcomes such as all-cause mortality, cardiovascular death, postoperative atrial fibrillation (AF), acute kidney injury (AKI), and spontaneous myocardial infarction (MI) between high GDF-15 levels and control groups. Subgroup analyses were conducted based on study design and GDF-15 cutoff levels. Publication bias was evaluated using funnel plot and Egger's test.
A total of 13 studies were included in the meta-analysis. The study revealed a significant association between elevated GDF-15 levels and increased all-cause mortality. Subgroup analysis showed a significant association in retrospective studies but not in prospective studies. Higher GDF-15 cutoff levels (>2 ng/mL) were more strongly associated with increased mortality than lower cutoff levels (≤2 ng/mL). Elevated GDF-15 levels were found to be significantly associated with increased risks of cardiovascular death, AKI, and spontaneous MI. No significant difference was observed in the incidence of postoperative AF. The overall adverse outcomes analysis showed no significant difference. Subgroup analyses suggested significant associations primarily observed in studies with higher GDF-15 cutoffs.
Elevated GDF-15 levels are associated with increased risks of all-cause mortality, cardiovascular death, AKI, and spontaneous MI in patients undergoing cardiovascular interventions. Due to the heterogeneity of the studies, including variations in surgical techniques, the conclusions should be interpreted with caution.
CRD42024582279, https://www.crd.york.ac.uk/PROSPERO/view/CRD42024582279.
本系统评价和荟萃分析旨在评估生长分化因子-15（GDF-15）对接受心血管介入治疗患者不良结局的预测作用。
在PubMed、EMBASE、Cochrane图书馆和Web of Science数据库中进行全面的文献检索。荟萃分析使用风险比（HR）和比值比（OR）来比较高GDF-15水平组与对照组之间的全因死亡率、心血管死亡、术后心房颤动（AF）、急性肾损伤（AKI）和自发性心肌梗死（MI）等结局。基于研究设计和GDF-15截断水平进行亚组分析。使用漏斗图和Egger检验评估发表偏倚。
荟萃分析共纳入13项研究。研究显示GDF-15水平升高与全因死亡率增加之间存在显著关联。亚组分析显示，回顾性研究中有显著关联，前瞻性研究中则无。较高的GDF-15截断水平（>2 ng/mL）比较低的截断水平（≤2 ng/mL）与死亡率增加的关联更强。发现GDF-15水平升高与心血管死亡、AKI和自发性MI风险增加显著相关。术后AF发生率未观察到显著差异。总体不良结局分析显示无显著差异。亚组分析表明，主要在GDF-15截断值较高的研究中观察到显著关联。
接受心血管介入治疗的患者中，GDF-15水平升高与全因死亡率、心血管死亡、AKI和自发性MI风险增加相关。由于研究的异质性，包括手术技术的差异，对结论的解释应谨慎。
PROSPERO注册编号：CRD42024582279，https://www.crd.york.ac.uk/PROSPERO/view/CRD42024582279 。
