Plasma GAS6 Predicts Mortality Risk in Acute Heart Failure Patients: Insights from the DRAGON-HF trial

Abstract Background: Growth arrest-specific 6 (GAS6) is a biomarker related to inflammation, fibrosis, as well as platelet function. Knockout of GAS6 in mice subjected to pressure overloading protects against cardiac hypertrophy and dysfunction. Nonetheless, the association between plasma GAS6 levels and acute heart failure (AHF) in patients is still unknown. Methods: We measured GAS6 concentrations in 1039 patients with AHF who were enrolled in the DRAGON-HF trial. We followed them and examine future clinical events. Results: In total, there were 195 primary endpoints of all-cause mortality and 135 secondary endpoints of cardiovascular death during the median follow-up period of 889 days. The higher level of GAS6 was associated with higher rates of all-cause and cardiovascular mortality (P<0.05). Baseline plasma GAS6 levels were still strongly correlated with clinical outcomes in different models after adjustment for clinical factors and N-terminal pro-brain natriuretic peptide (NT-proBNP, P<0.05). GAS6 could further distinguish the risks of clinical outcomes based on the NT-proBNP measurement. Conclusion: We demonstrated that elevated plasma GAS6 levels were associated with an increased risk of all-cause and cardiovascular death in patients with AHF. Registration Number: NCT03727828 (DRAGON-HF trial) https://clinicaltrials.gov/ct2/show/NCT03727828?term=NCT03727828&draw=2&rank=1.