Growth Differentiation Factor-15 Predicts Mortality and Heart Failure Exacerbation But Not Ventricular Arrhythmias in Patients With Cardiomyopathy

• Published in: Journal of the American Heart Association 2023-02, Vol.12 (3), p.e8023-e8023
• Main Authors: Binder, M Scott, Yanek, Lisa R, Yang, Wanjun, Butcher, Barbara, Norgard, Sanaz, Marine, Joseph E, Kolandaivelu, Aravindan, Chrispin, Jonathan, Fedarko, Neal S, Calkins, Hugh, O'Rourke, Brian, Wu, Katherine C, Tomaselli, Gordon F, Barth, Andreas S
• Format: Article
• Language: English
• Subjects: Aged; arrhythmias; Arrhythmias, Cardiac - complications; Arrhythmias, Cardiac - diagnosis; Arrhythmias, Cardiac - therapy; Biomarkers; Cardiomyopathies - complications; Cardiomyopathies - therapy; Death, Sudden, Cardiac - epidemiology; Death, Sudden, Cardiac - etiology; Death, Sudden, Cardiac - prevention & control; Defibrillators, Implantable; Female; Growth Differentiation Factor 15; heart failure; Heart Failure - complications; Heart Failure - diagnosis; Heart Failure - therapy; Humans; Male; Middle Aged; mortality; Original Research; Retrospective Studies; Tachycardia, Ventricular - complications; Tachycardia, Ventricular - diagnosis; Tachycardia, Ventricular - therapy; Ventricular Fibrillation - complications; Ventricular Fibrillation - diagnosis; Ventricular Fibrillation - therapy
• ISSN: 2047-9980; 2047-9980
• DOI: 10.1161/JAHA.122.026003

Background Heart failure (HF) has been increasing in prevalence, and a need exists for biomarkers with improved predictive and prognostic ability. GDF-15 (growth differentiation factor-15) is a novel biomarker associated with HF mortality, but no serial studies of GDF-15 have been conducted. This study aimed to investigate the association between GDF-15 levels over time and the occurrence of ventricular arrhythmias, HF hospitalizations, and all-cause mortality. Methods and Results We used a retrospective case-control design to analyze 148 patients with ischemic and nonischemic cardiomyopathies and primary prevention implantable cardioverter-defibrillator (ICD) from the PROSe-ICD (Prospective Observational Study of the ICD in Sudden Cardiac Death Prevention) cohort. Patients had blood drawn every 6 months and after each appropriate ICD therapy and were followed for a median follow-up of 4.6 years, between 2005 to 2019. We compared serum GDF-15 levels within ±90 days of an event among those with a ventricular tachycardia/fibrillation event requiring ICD therapies and those hospitalized for decompensated HF. A comparator/control group comprised patients with GDF-15 levels available during 2-year follow-up periods without events. Median follow-up was 4.6 years in the 148 patients studied (mean age 58±12, 27% women). The HF cohort had greater median GDF-15 values within 90 days (1797 pg/mL) and 30 days (2039 pg/mL) compared with the control group (1062 pg/mL, both