Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2023, 167(3):263-271 | DOI: 10.5507/bp.2022.017

Risk stratification using growth differentiation factor 15 in patients undergoing transcatheter aortic valve implantation

Martin Sluka1, Martin Hutyra1, Radomir Nykl1, Jiri Ostransky1, Tomas Furst2, Pavla Petrova3, Jan Precek1, Stepan Hudec1, Milos Taborsky1
1 Department of Internal Medicine I - Cardiology, University Hospital Olomouc, I. P. Pavlova 6, 779 00, Czech Republic
2 Department of Mathematical Analysis and Applications of Mathematics, Faculty of Science, Palacky University Olomouc, Czech Republic
3 Department of Clinical Biochemistry, University Hospital Olomouc, I. P. Pavlova 6, 779 00, Czech Republic

Aims: Growth differentiation factor 15 (GDF15) shows potential predictive value in various cardiac conditions. We investigated relationships between GDF15 and clinical or procedural outcomes in patients with severe aortic stenosis undergoing transcatheter aortic valve implantation (TAVI) in order to propose clinically useful predictive risk stratification model.

Methods: This prospective single-center registry enrolled 88 consecutive patients with severe symptomatic aortic stenosis treated with TAVI. Clinical parameters were collected and biomarkers including GDF-15 were measured within 24 h before TAVI. All relevant clinical outcomes according to the Valve Academic Research Consortium-2 were collected over the follow-up period.

Results: The cohort included 52.3% of females. The mean age of study participants was 81 years; the mean Society of Thoracic Surgeons (STS) score and logistic EuroSCORE were 3.6% and 15.4%, respectively. The mortality over the entire follow-up period was 10.2%; no death was observed within the first 30 days following TAVI. Univariate analysis showed significant associations between GDF15 and mortality (P=0.0006), bleeding (P=0.0416) and acute kidney injury (P=0.0399). A standard multivariate logistic regression model showed GDF-15 as the only significant predictor of mortality (P=0.003); the odds ratio corresponding to an increase in GDF15 of 1000 pg/mL was 1.22. However, incremental predictive value was not observed when the STS score was combined with GDF15 in this predictive model.

Conclusions: Based on our observations, preprocedural elevated GDF15 levels are associated with increased mortality and demonstrate their additional value in predicting adverse clinical outcomes in a TAVI population.

Keywords: transcatheter valve implantation (TAVI), risk stratification, biomarker, growth differentiation factor 15 (GDF15)

Received: January 24, 2022; Revised: February 3, 2022; Accepted: March 24, 2022; Prepublished online: April 12, 2022; Published: September 21, 2023  Show citation

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Sluka, M., Hutyra, M., Nykl, R., Ostransky, J., Furst, T., Petrova, P., ... Taborsky, M. (2023). Risk stratification using growth differentiation factor 15 in patients undergoing transcatheter aortic valve implantation. Biomedical papers, 167(3), 263-271. doi: 10.5507/bp.2022.017
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