title: Growth differentiation factor-15 predicts the prognoses of patients with acute coronary syndrome: a meta-analysis.
abstract: BACKGROUND
  Recent studies have shown Growth differentiation factor-15 (GDF-15) that is a member of the transforming growth factor β (TGF-β) superfamily might be a potential predictive cytokine for the prognosis of Acute coronary syndrome (ACS). However, there are discrepancies in these studies.
  
  
  METHODS
  Publication searches of the PubMed/Medline and EMBASE databases were performed without any time or ethnicity restrictions. The inclusion and exclusion criteria, when clear, were addressed. Random effects models were used for all analyses. Publication bias was tested using funnel plots and the Egger test.
  
  
  RESULTS
  We identified eight eligible studies that provided mortality data. Five of these studies provided recurrent myocardial infarction (MI) data. The maximal duration of follow-up ranged from 6 months to 6 years. A significant association was found between the patients with the highest and lowest GDF-15 levels (overall analyses) in terms of mortality (p < 0.00001; RR = 6.08; 95 % CI = 4.79-7.71) and recurrent MI (p < 0.00001; RR = 1.76; 95 % CI = 1.49-2.07). We also found significant associations between the subgroup analyses stratified by ACS types, cutoff points and follow-up durations (p < 0.001). The combined hazard ratio was high for GDF-15 to ACS (HR = 1.656, 95 % CI = 1.467-1.871).
  
  
  CONCLUSIONS
  High plasma GDF-15 levels are associated with an increased risk of mortality and recurrent MI in patients with ACS.
authors.affiliation: Department of Cardiovascular, Ningbo First Hospital, Ningbo, 315010, China.|Department of Cardiovascular, Shangrao People 's Hospital, Shangrao, 334000, China.
authors.forename: Shangshi
authors.initials: S
authors.lastname: Zhang
authors.affiliation: Department of Medical Oncology, Institute of Clinical Science, Sir Run Run Shaw Hospital, Medical School of Zhejiang University, Hangzhou, 310029, China.
authors.forename: Dongjun
authors.initials: D
authors.lastname: Dai
authors.affiliation: Department of Medical Oncology, Institute of Clinical Science, Sir Run Run Shaw Hospital, Medical School of Zhejiang University, Hangzhou, 310029, China.
authors.forename: Xian
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Cardiovascular, Shangrao People 's Hospital, Shangrao, 334000, China.
authors.forename: Hongyan
authors.initials: H
authors.lastname: Zhu
authors.affiliation: Department of Medical Oncology, Institute of Clinical Science, Sir Run Run Shaw Hospital, Medical School of Zhejiang University, Hangzhou, 310029, China.
authors.forename: Hongchuan
authors.initials: H
authors.lastname: Jin
authors.affiliation: Department of Cardiovascular, Ningbo First Hospital, Ningbo, 315010, China.
authors.forename: Ruochi
authors.initials: R
authors.lastname: Zhao
authors.affiliation: Department of Medical Oncology, Institute of Clinical Science, Sir Run Run Shaw Hospital, Medical School of Zhejiang University, Hangzhou, 310029, China.
authors.forename: Liting
authors.initials: L
authors.lastname: Jiang
authors.affiliation: Department of Cardiovascular, Ningbo First Hospital, Ningbo, 315010, China.
authors.forename: Qi
authors.initials: Q
authors.lastname: Lu
authors.affiliation: Department of Cardiovascular, Ningbo First Hospital, Ningbo, 315010, China.
authors.forename: Fengying
authors.initials: F
authors.lastname: Yi
authors.affiliation: Department of Cardiovascular, Ningbo First Hospital, Ningbo, 315010, China.
authors.forename: Xiangxiang
authors.initials: X
authors.lastname: Wan
authors.affiliation: Department of Cardiovascular, Ningbo First Hospital, Ningbo, 315010, China. hanbincui@hotmail.com.
authors.forename: Hanbin
authors.initials: H
authors.lastname: Cui
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood* / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D015415:Biomarkers / Q000097:blood; D055436:Growth Differentiation Factor 15 / Q000097:blood*; D006801:Humans; D009203:Myocardial Infarction / Q000097:blood* / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011379:Prognosis; D012008:Recurrence; D012307:Risk Factors; D013997:Time Factors; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; C526140:GDF15 protein, human; D055436:Growth Differentiation Factor 15