Growth differentiation factor-15 (GDF15) is considered a poor prognosis biomarker in many cardiovascular pathological situations; however, its interest in the field of neurovascular disease such as ischemic stroke has been poorly explored so far. Our work consisted of evaluating GDF15 levels in patients hospitalized in the acute phase of ischemic stroke, who received a revascularization treatment either by fibrinolysis or thrombectomy.

The main objective of our study was to evaluate the association between plasma levels of GDF15 and functional recovery at 3 months.

In total, 174 patients were included between January 15th and September 30th 2017 in the University Hospital of Dijon. Biological samples were taken at the patient admission (D0) and at D1, D3 and D7. Patients were contacted by phone at 3 months in order to evaluate the Rankin score (functional disability). GDF15 plasma levels were measured by an ELISA method.

In all patients, the GDF15 plasma levels at D0, D1, D3 and D7 were significantly higher in patients with a sequelae handicap (Rankin score ≥ 2) compared to patients without disabilities (Rankin score to 0 or 1). In a univariate logistic regression analysis, we found a significant increase in the odds ratio (OR) of the risk of having a Rankin score ≥ 2 with a GDF15 plasma level found in the last tertile. In addition, GDF15 levels were significantly higher in patients treated with thrombectomy than with fibrinolysis.

Therefore, GDF15 appears as a relevant biomarker of poor prognosis and of sequelae handicap after ischemic stroke. Plasma levels of GDF15 being most important in patients with thrombectomy than with fibrinolysis, they may reflect the difference of the initial clinical severity, related to an occlusion of a proximal artery. Finally, after thrombectomy, GDF15 decrease could signal effective recanalization of the occluded artery.