Growth Differentiation Factor 15 as a Biomarker for Risk Stratification in the Cardiothoracic Surgery Intensive Care Unit

Growth Differentiation Factor 15 (GDF15) is an emerging biomarker that significantly increases during acute stress responses, such as infections, and is moderately elevated in chronic and inflammation-driven conditions. While evidence suggests that high levels of GDF15 in cardiac surgery are associa...

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Main Authors: Ricardo Ferreira, Tiago R. Velho, Rafael Maniés Pereira, Dora Pedroso, Beatriz Draiblate, Susana Constantino, Ângelo Nobre, Ana G. Almeida, Luís F. Moita, Fausto Pinto
Format: Article
Language:English
Published: MDPI AG 2024-12-01
Series:Biomolecules
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Online Access:https://www.mdpi.com/2218-273X/14/12/1593
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author Ricardo Ferreira
Tiago R. Velho
Rafael Maniés Pereira
Dora Pedroso
Beatriz Draiblate
Susana Constantino
Ângelo Nobre
Ana G. Almeida
Luís F. Moita
Fausto Pinto
author_facet Ricardo Ferreira
Tiago R. Velho
Rafael Maniés Pereira
Dora Pedroso
Beatriz Draiblate
Susana Constantino
Ângelo Nobre
Ana G. Almeida
Luís F. Moita
Fausto Pinto
author_sort Ricardo Ferreira
collection DOAJ
description Growth Differentiation Factor 15 (GDF15) is an emerging biomarker that significantly increases during acute stress responses, such as infections, and is moderately elevated in chronic and inflammation-driven conditions. While evidence suggests that high levels of GDF15 in cardiac surgery are associated with worse outcomes, its utility as an evaluator of early postoperative complications remains unclear. This study aims to characterize the postoperative profile of GDF15 in patients undergoing isolated surgical aortic valve replacement, evaluating its association with short-term outcomes. Serum samples from patients undergoing cardiac surgery were collected preoperatively and at defined postoperative time points (1 h, 6 h, 12 h, 24 h, and 48 h) to measure GDF15 levels. GDF15 levels significantly increased after surgery, peaking at 6 h. A positive correlation was observed between GDF15 levels and both cardiopulmonary bypass and aortic cross-clamp times. Notably, patients who developed postoperative acute kidney injury (AKI) or required prolonged hemodynamic support had significantly higher GDF15 levels, with increased mechanical ventilation time and extended intensive care unit length of stay. Furthermore, GDF15 levels correlated with postoperative SOFA scores at 24 h after surgery. GDF15 may be a valuable biomarker for risk stratification and guiding therapeutic decisions in cardiac surgery patients. Higher GDF15 levels were significantly associated with prolonged hemodynamic support, postoperative AKI, and measures of illness severity.
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spelling doaj-art-6d7fdad457d044e9b5cf91964ffddf332025-08-20T02:43:29ZengMDPI AGBiomolecules2218-273X2024-12-011412159310.3390/biom14121593Growth Differentiation Factor 15 as a Biomarker for Risk Stratification in the Cardiothoracic Surgery Intensive Care UnitRicardo Ferreira0Tiago R. Velho1Rafael Maniés Pereira2Dora Pedroso3Beatriz Draiblate4Susana Constantino5Ângelo Nobre6Ana G. Almeida7Luís F. Moita8Fausto Pinto9Department of Cardiothoracic Surgery, Hospital de Santa Maria, Unidade Local de Saúde de Santa Maria, 1649-028 Lisbon, PortugalDepartment of Cardiothoracic Surgery, Hospital de Santa Maria, Unidade Local de Saúde de Santa Maria, 1649-028 Lisbon, PortugalDepartment of Cardiothoracic Surgery, Hospital de Santa Maria, Unidade Local de Saúde de Santa Maria, 1649-028 Lisbon, PortugalInnate Immunity and Inflammation Laboratory, Instituto Gulbenkian de Ciência, 2780-156 Oeiras, PortugalDepartment of Cardiothoracic Surgery, Hospital de Santa Maria, Unidade Local de Saúde de Santa Maria, 1649-028 Lisbon, PortugalAngiogenesis Unit, Centro Cardiovascular da Universidade de Lisboa (CCUL@RISE), Faculdade de Medicina da Universidade de Lisboa, 1649-028 Lisbon, PortugalDepartment of Cardiothoracic Surgery, Hospital de Santa Maria, Unidade Local de Saúde de Santa Maria, 1649-028 Lisbon, PortugalDepartment of Cardiology, Hospital de Santa Maria, Unidade Local de Saúde de Santa Maria, 1649-028 Lisbon, PortugalInnate Immunity and Inflammation Laboratory, Instituto Gulbenkian de Ciência, 2780-156 Oeiras, PortugalDepartment of Cardiology, Hospital de Santa Maria, Unidade Local de Saúde de Santa Maria, 1649-028 Lisbon, PortugalGrowth Differentiation Factor 15 (GDF15) is an emerging biomarker that significantly increases during acute stress responses, such as infections, and is moderately elevated in chronic and inflammation-driven conditions. While evidence suggests that high levels of GDF15 in cardiac surgery are associated with worse outcomes, its utility as an evaluator of early postoperative complications remains unclear. This study aims to characterize the postoperative profile of GDF15 in patients undergoing isolated surgical aortic valve replacement, evaluating its association with short-term outcomes. Serum samples from patients undergoing cardiac surgery were collected preoperatively and at defined postoperative time points (1 h, 6 h, 12 h, 24 h, and 48 h) to measure GDF15 levels. GDF15 levels significantly increased after surgery, peaking at 6 h. A positive correlation was observed between GDF15 levels and both cardiopulmonary bypass and aortic cross-clamp times. Notably, patients who developed postoperative acute kidney injury (AKI) or required prolonged hemodynamic support had significantly higher GDF15 levels, with increased mechanical ventilation time and extended intensive care unit length of stay. Furthermore, GDF15 levels correlated with postoperative SOFA scores at 24 h after surgery. GDF15 may be a valuable biomarker for risk stratification and guiding therapeutic decisions in cardiac surgery patients. Higher GDF15 levels were significantly associated with prolonged hemodynamic support, postoperative AKI, and measures of illness severity.https://www.mdpi.com/2218-273X/14/12/1593GDF15cardiac surgerycardiopulmonary bypasssurgical aortic valve replacementhemodynamic supportacute kidney injury
spellingShingle Ricardo Ferreira
Tiago R. Velho
Rafael Maniés Pereira
Dora Pedroso
Beatriz Draiblate
Susana Constantino
Ângelo Nobre
Ana G. Almeida
Luís F. Moita
Fausto Pinto
Growth Differentiation Factor 15 as a Biomarker for Risk Stratification in the Cardiothoracic Surgery Intensive Care Unit
Biomolecules
GDF15
cardiac surgery
cardiopulmonary bypass
surgical aortic valve replacement
hemodynamic support
acute kidney injury
title Growth Differentiation Factor 15 as a Biomarker for Risk Stratification in the Cardiothoracic Surgery Intensive Care Unit
title_full Growth Differentiation Factor 15 as a Biomarker for Risk Stratification in the Cardiothoracic Surgery Intensive Care Unit
title_fullStr Growth Differentiation Factor 15 as a Biomarker for Risk Stratification in the Cardiothoracic Surgery Intensive Care Unit
title_full_unstemmed Growth Differentiation Factor 15 as a Biomarker for Risk Stratification in the Cardiothoracic Surgery Intensive Care Unit
title_short Growth Differentiation Factor 15 as a Biomarker for Risk Stratification in the Cardiothoracic Surgery Intensive Care Unit
title_sort growth differentiation factor 15 as a biomarker for risk stratification in the cardiothoracic surgery intensive care unit
topic GDF15
cardiac surgery
cardiopulmonary bypass
surgical aortic valve replacement
hemodynamic support
acute kidney injury
url https://www.mdpi.com/2218-273X/14/12/1593
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