Elevated circulating growth differentiation factor-15 (GDF-15) levels at hospital admission were associated with higher mortality risk in patients hospitalized with acute heart failure (AHF), according to a meta-analysis published in Clinical Cardiology.

The analysis included prospective cohort studies, retrospective cohorts, and post-hoc trial analyses identified through systematic searches of PubMed, Embase, and Web of Science. Eligible studies included adults hospitalized with AHF who underwent blood GDF-15 measurement at admission or within 48 hours. All-cause mortality was evaluated across studies using random-effects models.

A total of 10 studies involving 3724 patients with AHF were included in the analysis. Patients with elevated admission GDF-15 levels had a significantly greater risk of all-cause mortality than those with lower levels (risk ratio [RR] 2.82; 95% confidence interval [CI] 2.39–3.32; p<0.001). No significant between-study heterogeneity was identified (I²=0%).

Sensitivity analyses showed consistent findings, with leave-one-out analyses yielding RR estimates ranging from 2.73 to 3.00. Similar associations were observed in high-quality studies with Newcastle-Ottawa Scale scores of 8 or greater (RR 2.72; 95% CI 2.26–3.27).

Subgroup analyses demonstrated consistent associations across Asian and Western populations, prospective and retrospective study designs, sampling times, assay methods, cutoff definitions, follow-up duration, and adjustment for B-type natriuretic peptide (BNP) or N-terminal pro-BNP. No significant publication bias was detected.

The findings showed that elevated admission GDF-15 levels were consistently associated with higher mortality risk in hospitalized patients with AHF. The analysis supports the potential role of GDF-15 in early risk stratification in AHF.