Growth differentiation factor 15 (GDF-15) in patients admitted for acute heart failure: results from the RELAX-AHF study.

Abstract

BACKGROUND:

Growth differentiation factor 15 (GDF-15) was found to be upregulated in patients with chronic heart failure (HF) and associated with disease severity, however, data on patients with acute heart failure (AHF) is lacking.

METHODS AND RESULTS:

Levels of GDF-15 were measured at pre-specified time-points (baseline and at days 2, 5, 14, and 60) in patients enrolled in the placebo-controlled RELAXin in Acute Heart Failure (RELAX-AHF) study, which examined the effect of serelaxin in 1161 patients with AHF, systolic blood pressure >125 mmHg, and mild to moderate renal impairment. Neither baseline nor changes in GDF-15 were associated with the degree of dyspnoea or dyspnoea relief. After adjustment for baseline characteristics, baseline GDF-15 was not associated with the composite endpoint of heart failure or renal failure (HF/RF) readmission at 60 days/cardiovascular (CV) death or CV death at 180 days. In contrast, larger increases in GDF-15 levels at days 2 and 14 were associated with a greater risk of 60-day HF/RF rehospitalizations/CV death and CV death at 180 days. Serelaxin treatment was associated with significantly larger decreases of GDF-15 at days 2 and 5 than placebo.

CONCLUSIONS:

In AHF patients enrolled in the RELAX-AHF study, increases in GDF-15 levels, but not baseline measurements, were associated with a greater likelihood of adverse outcomes. Serelaxin administration was associated with greater decreases in GDF-15 compared with placebo.

• Authors: Gad Cotter, Adriaan A Voors, Margaret F Prescott, G Michael Felker, Gerasimos Filippatos, Barry H Greenberg, Peter S Pang, Piotr Ponikowski, Olga Milo, Tsushung A Hua, Min Qian, Thomas M Severin, John R Teerlink, Marco Metra, Beth A Davison
• Journal: European journal of heart failure (Eur J Heart Fail) Vol. 17 Issue 11 Pg. 1133-43 (Nov 2015) ISSN: 1879-0844 [Electronic] England
• PMID: 26333529 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: © 2015 The Authors European Journal of Heart Failure © 2015 European Society of Cardiology.

Chemical References

• Cardiovascular Agents
• Growth Differentiation Factor 15
• Peptide Fragments
• Recombinant Proteins
• pro-brain natriuretic peptide (1-76)
• serelaxin protein, human
• Natriuretic Peptide, Brain
• Relaxin

Topics

• Acute Disease
• Aged
• Aged, 80 and over
• Cardiovascular Agents (administration & dosage)
• Double-Blind Method
• Female
• Growth Differentiation Factor 15 (blood)
• Heart Failure (blood, diagnosis, drug therapy, mortality, physiopathology)
• Hospitalization
• Humans
• Male
• Middle Aged
• Mortality
• Natriuretic Peptide, Brain (blood)
• Peptide Fragments (blood)
• Recombinant Proteins (administration & dosage)
• Relaxin (administration & dosage)
• Severity of Illness Index
• Statistics as Topic
• Symptom Flare Up
• Treatment Outcome