{"title":"GDF-15对心血管干预后不良结局的预测作用：系统回顾和荟萃分析。","authors":"Xiaotong Jia, Junwei Gao, Zeyou Qi, Jun Ma","doi":"10.31083/RCM28279","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>This systematic review and meta-analysis aimed to evaluate the predictive effect of Growth Differentiation Factor-15 (GDF-15) on adverse outcomes in patients undergoing cardiovascular interventions.</p><p><strong>Method: </strong>A comprehensive literature search was performed across PubMed, EMBASE, Cochrane Library, and Web of Science databases. The meta-analysis used hazard ratios (HR) and odds ratios (OR) to compare outcomes such as all-cause mortality, cardiovascular death, postoperative atrial fibrillation (AF), acute kidney injury (AKI), and spontaneous myocardial infarction (MI) between high GDF-15 levels and control groups. Subgroup analyses were conducted based on study design and GDF-15 cutoff levels. Publication bias was evaluated using funnel plot and Egger's test.</p><p><strong>Results: </strong>A total of 13 studies were included in the meta-analysis. The study revealed a significant association between elevated GDF-15 levels and increased all-cause mortality. Subgroup analysis showed a significant association in retrospective studies but not in prospective studies. Higher GDF-15 cutoff levels (>2 ng/mL) were more strongly associated with increased mortality than lower cutoff levels (≤2 ng/mL). Elevated GDF-15 levels were found to be significantly associated with increased risks of cardiovascular death, AKI, and spontaneous MI. No significant difference was observed in the incidence of postoperative AF. The overall adverse outcomes analysis showed no significant difference. Subgroup analyses suggested significant associations primarily observed in studies with higher GDF-15 cutoffs.</p><p><strong>Conclusion: </strong>Elevated GDF-15 levels are associated with increased risks of all-cause mortality, cardiovascular death, AKI, and spontaneous MI in patients undergoing cardiovascular interventions. Due to the heterogeneity of the studies, including variations in surgical techniques, the conclusions should be interpreted with caution.</p><p><strong>The prospero registration: </strong>CRD42024582279, https://www.crd.york.ac.uk/PROSPERO/view/CRD42024582279.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 4","pages":"28279"},"PeriodicalIF":1.9000,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059790/pdf/","citationCount":"0","resultStr":"{\"title\":\"Predictive Effect of GDF-15 on Adverse Outcomes After Cardiovascular Interventions: A Systematic Review and Meta-Analysis.\",\"authors\":\"Xiaotong Jia, Junwei Gao, Zeyou Qi, Jun Ma\",\"doi\":\"10.31083/RCM28279\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>This systematic review and meta-analysis aimed to evaluate the predictive effect of Growth Differentiation Factor-15 (GDF-15) on adverse outcomes in patients undergoing cardiovascular interventions.</p><p><strong>Method: </strong>A comprehensive literature search was performed across PubMed, EMBASE, Cochrane Library, and Web of Science databases. The meta-analysis used hazard ratios (HR) and odds ratios (OR) to compare outcomes such as all-cause mortality, cardiovascular death, postoperative atrial fibrillation (AF), acute kidney injury (AKI), and spontaneous myocardial infarction (MI) between high GDF-15 levels and control groups. Subgroup analyses were conducted based on study design and GDF-15 cutoff levels. Publication bias was evaluated using funnel plot and Egger's test.</p><p><strong>Results: </strong>A total of 13 studies were included in the meta-analysis. The study revealed a significant association between elevated GDF-15 levels and increased all-cause mortality. Subgroup analysis showed a significant association in retrospective studies but not in prospective studies. Higher GDF-15 cutoff levels (>2 ng/mL) were more strongly associated with increased mortality than lower cutoff levels (≤2 ng/mL). Elevated GDF-15 levels were found to be significantly associated with increased risks of cardiovascular death, AKI, and spontaneous MI. No significant difference was observed in the incidence of postoperative AF. The overall adverse outcomes analysis showed no significant difference. Subgroup analyses suggested significant associations primarily observed in studies with higher GDF-15 cutoffs.</p><p><strong>Conclusion: </strong>Elevated GDF-15 levels are associated with increased risks of all-cause mortality, cardiovascular death, AKI, and spontaneous MI in patients undergoing cardiovascular interventions. Due to the heterogeneity of the studies, including variations in surgical techniques, the conclusions should be interpreted with caution.</p><p><strong>The prospero registration: </strong>CRD42024582279, https://www.crd.york.ac.uk/PROSPERO/view/CRD42024582279.</p>\",\"PeriodicalId\":20989,\"journal\":{\"name\":\"Reviews in cardiovascular medicine\",\"volume\":\"26 4\",\"pages\":\"28279\"},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2025-04-16\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059790/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Reviews in cardiovascular medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.31083/RCM28279\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/4/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q3\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Reviews in cardiovascular medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.31083/RCM28279","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/4/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
摘要
背景：本系统综述和荟萃分析旨在评估生长分化因子-15 （GDF-15）对接受心血管干预患者不良结局的预测作用。方法：通过PubMed、EMBASE、Cochrane Library和Web of Science数据库进行全面的文献检索。荟萃分析使用风险比（HR）和优势比（OR）来比较高GDF-15水平和对照组之间的全因死亡率、心血管死亡、术后心房颤动（AF）、急性肾损伤（AKI）和自发性心肌梗死（MI）等结果。根据研究设计和GDF-15截止水平进行亚组分析。采用漏斗图和Egger检验评价发表偏倚。结果：meta分析共纳入13项研究。该研究揭示了GDF-15水平升高与全因死亡率增加之间的显著关联。亚组分析显示，在回顾性研究中有显著相关性，而在前瞻性研究中无显著相关性。较高的GDF-15切断水平（≤2 ng/mL）与死亡率增加的相关性比较低的切断水平（≤2 ng/mL）更强。研究发现，GDF-15水平升高与心血管死亡、AKI和自发性心肌梗死的风险增加显著相关。在术后AF发生率方面没有观察到显著差异。总体不良结局分析没有发现显著差异。亚组分析显示，主要在GDF-15临界值较高的研究中观察到显著关联。结论：在接受心血管干预的患者中，GDF-15水平升高与全因死亡率、心血管死亡、AKI和自发性心肌梗死风险增加相关。由于研究的异质性，包括手术技术的差异，结论应谨慎解释。普洛斯彼罗注册：CRD42024582279， https://www.crd.york.ac.uk/PROSPERO/view/CRD42024582279。
Predictive Effect of GDF-15 on Adverse Outcomes After Cardiovascular Interventions: A Systematic Review and Meta-Analysis.
Background: This systematic review and meta-analysis aimed to evaluate the predictive effect of Growth Differentiation Factor-15 (GDF-15) on adverse outcomes in patients undergoing cardiovascular interventions.
Method: A comprehensive literature search was performed across PubMed, EMBASE, Cochrane Library, and Web of Science databases. The meta-analysis used hazard ratios (HR) and odds ratios (OR) to compare outcomes such as all-cause mortality, cardiovascular death, postoperative atrial fibrillation (AF), acute kidney injury (AKI), and spontaneous myocardial infarction (MI) between high GDF-15 levels and control groups. Subgroup analyses were conducted based on study design and GDF-15 cutoff levels. Publication bias was evaluated using funnel plot and Egger's test.
Results: A total of 13 studies were included in the meta-analysis. The study revealed a significant association between elevated GDF-15 levels and increased all-cause mortality. Subgroup analysis showed a significant association in retrospective studies but not in prospective studies. Higher GDF-15 cutoff levels (>2 ng/mL) were more strongly associated with increased mortality than lower cutoff levels (≤2 ng/mL). Elevated GDF-15 levels were found to be significantly associated with increased risks of cardiovascular death, AKI, and spontaneous MI. No significant difference was observed in the incidence of postoperative AF. The overall adverse outcomes analysis showed no significant difference. Subgroup analyses suggested significant associations primarily observed in studies with higher GDF-15 cutoffs.
Conclusion: Elevated GDF-15 levels are associated with increased risks of all-cause mortality, cardiovascular death, AKI, and spontaneous MI in patients undergoing cardiovascular interventions. Due to the heterogeneity of the studies, including variations in surgical techniques, the conclusions should be interpreted with caution.
The prospero registration: CRD42024582279, https://www.crd.york.ac.uk/PROSPERO/view/CRD42024582279.
期刊介绍：
RCM is an international, peer-reviewed, open access journal. RCM publishes research articles, review papers and short communications on cardiovascular medicine as well as research on cardiovascular disease. We aim to provide a forum for publishing papers which explore the pathogenesis and promote the progression of cardiac and vascular diseases. We also seek to establish an interdisciplinary platform, focusing on translational issues, to facilitate the advancement of research, clinical treatment and diagnostic procedures. Heart surgery, cardiovascular imaging, risk factors and various clinical cardiac & vascular research will be considered.
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