• Yabo Wang, Chao Zhen, Rui Wang, and Ge Wang.
• Department of Emergency, Qilu Hospital of Shandong University (Qingdao), Qingdao, Shandong, China.
• Am J Emerg Med. 2019 Jul 1; 37 (7): 1346-1352.

BackgroundWe aimed to analyse the association between high-level growth-differentiation factor-15 (GDF-15) and mortality, recurrent MI and heart failure compared to low-level GDF-15 in patients with acute coronary syndrome (ACS).MethodsPubMed and EMBASE were searched from their commencement to December 2017 for qualified studies that evaluated the associations between GDF-15 and ACS. Risk ratios were synthesized with random effect meta-analysis. Publication bias and sensitivity analyses were also conducted.ResultsA total of thirteen studies and 43,547 participants were analyzed systematically in our meta-analysis. Our study showed a significant association between GDF-15 values and mortality (p = 0.000, RR = 6.75, 95% CI = 5.81-7.84) and recurrent MI (p = 0.000, RR = 1.95, 95% CI = 1.72-2.21) in the overall analyses. Subgroup analyses revealed similar results. However, there was evidence of heterogeneity in the study of heart failure, whose overall RR was 6.66, with an I2 of 87.3%.ConclusionThere was a significant association between high-level GDF-15 and mortality, recurrent MI in patients with ACS. We need more data to research the risk stratification of heart failure in ACS patients in the future.Copyright © 2019 Elsevier Inc. All rights reserved.

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