Meta-analysis links elevated GDF-15 to mortality in acute heart failure

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Clinical cardiology Published May 6, 2026 Medically reviewed May 11, 2026 Study authors: Jin Pingkui, Geng Yanjie, Huo Erwei, Xue Yanhong, You Daofeng, Zheng Qinghou PubMed ↗ DOI ↗ By Dr. Amelia Tan, PhD · Internal Medicine & Chronic Disease

Key Takeaway

Consider elevated admission GDF-15 as a marker of increased mortality risk in acute heart failure.

This is a meta-analysis of studies in adult patients with acute heart failure who had blood GDF-15 measured on admission. The analysis synthesized data from 3724 patients to assess the association between elevated admission circulating GDF-15 levels and all-cause mortality.

The key finding was that high admission GDF-15 levels were significantly associated with an increased mortality risk. The pooled effect size was a relative risk of 2.82, with a 95% confidence interval of 2.39 to 3.32 and a p-value less than 0.001.

The authors note that this association supports the potential role of GDF-15 in early risk stratification for acute heart failure. However, the analysis is limited by the observational nature of the included studies, which precludes causal conclusions.

Practice relevance is restrained to the supportive role in risk stratification, without implying a change in management. The meta-analysis does not report specific study locations, drug interventions, or adverse events.

Study Details

Study typeMeta analysis

Sample sizen = 3,724

EvidenceLevel 1

PublishedMay 2026

PMID42089382

View Original Abstract ↓

BACKGROUND: Growth differentiation factor-15 (GDF-15) is a stress-responsive biomarker implicated in inflammation and myocardial injury. Its prognostic value for mortality risk in acute heart failure (AHF) remains uncertain. This meta-analysis evaluated the association between elevated admission circulating GDF-15 levels and subsequent mortality in patients hospitalized with AHF. METHODS: PubMed, Embase, and Web of Science were systematically searched for prospective or retrospective cohort studies and post-hoc trial analyses enrolling adult AHF patients with blood GDF-15 measured on admission. Risk ratios (RRs) for all-cause mortality comparing high versus low GDF-15 categories were pooled using random-effects models incorporating the influence of potential heterogeneity. RESULTS: Ten studies with 3724 patients with AHF were included. Overall, high admission GDF-15 levels were significantly associated with increased mortality risk during follow-up (RR = 2.82, 95% CI: 2.39-3.32; p < 0.001), with no evidence of between-study inconsistency (I² = 0%). Sensitivity analyses confirmed robustness (leave-one-out RR range: 2.73-3.00), and results remained consistent in high-quality studies (NOS ≥ 8; RR = 2.72, 95% CI: 2.26-3.27). Subgroup analyses demonstrated similar associations across Asian and Western cohorts, prospective and retrospective designs, different sampling times (at admission to within 48 h), assay methods (ELISA vs. ECLIA), cutoff definitions, follow-up duration, and adjustment for BNP/NT-proBNP (all p for subgroup differences >0.05). No significant publication bias was detected (Egger's p = 0.59). CONCLUSIONS: Elevated circulating GDF-15 levels at admission are strongly associated with increased mortality risk in patients with AHF, supporting its potential role in early risk stratification.