Prognostic value of growth differentiation factor 15 and hepatocyte growth factor in 5-year mortality for patients with chronic heart failure / 中华老年医学杂志

ABSTRACT

Objective:To evaluate the value of growth differentiation factor 15(GDF-15)and hepatocyte growth factor(HGF)in mortality prediction for patients with chronic heart failure(CHF)during a 5-year follow-up.Methods:This prospective case-control study enrolled 141 CHF patients hospitalized at the First Affiliated Hospital of Anhui Medical University between August 2015 and September 2017, including 59 with preserved ejection fraction(HFpEF)and 82 with non-preserved ejection fraction(non-HFpEF). Using all-cause mortality as the endpoint during the 60-month follow-up, there were 93 cases in the survival group and 48 cases in the death group.Clinical baseline data of patients in the two groups were compared, and the prognostic value of GDF-15 and HGF for CHF was assessed using multivariate logistic regression analysis, receiver operating characteristic curves(ROC curves), the area under the ROC curve(AUC), and Kaplan-Meier survival curves.Results:The results of multivariate Logistic regression analysis showed that GDF-15, HGF, glomerular filtration rate, and body mass index were independent risk factors for CHF prognosis during the 60-month follow-up; The degrees of predictive ability on mortality in 60-months in patients with heart failure were estimated for GDF-15( AUC=0.769, 95% CI: 0.685-0.854), HGF( AUC=0.765, 95% CI: 0.676 to 0.854), body mass index( AUC=0.689, 95% CI: 0.594 to 0.783), and glomerular filtration rate( AUC=0.612, 95% CI: 0.518 to 0.705). The AUC values of GDF-15 and HGF were greater than those of the body mass index and the glomerular filtration rate.Using GDF-15=2 326 ng/L and HGF=1, 603 ng/L as the cut-off values, the Kaplan-Meier survival curves showed statistically significant differences in survival rates between the two groups( P<0.05)The mortality rate in the non-HFpEF group was higher when GDF15 ≥2, 326 ng/L and HGF ≥1, 603 ng/L(100%, 15/15)than that in the HFpEF group(50%, 2/4), and the difference was statistically significant( χ2=5.526, P<0.05). Conclusions:GDF-15, HGF, the estimated glomerular filtration rate and the body mass index are independent prognostic risk factors for CHF during a 60-month follow-up period.GDF-15 and HGF are independent predictors of all-cause death in patients with CHF, especially those with non-HFpEF during 5-years.