Risk stratification of major adverse cardiovascular events in heart failure patients undergoing coronary artery bypass grafting: an observational multicenter prospective study (PROFILE-HF)
https://doi.org/10.29001/2073-8552-2026-3125
Abstract
Introduction. Coronary artery bypass grafting (CABG) is a primary treatment for patients with coronary artery disease (CAD) and chronic heart failure (CHF) with multivessel atherosclerosis of the coronary arteries. However, major clinical studies demonstrate a persistent high risk of adverse cardiovascular events in this cohort, even after revascularization. Growth Differentiation Factor 15 (GDF-15), according to several studies, has high prognostic value in patients with CHF and CAD, including those who have undergone CABG. This finding requires confirmation in specially designed prospective multicenter studies.
Aim: To present a study protocol with the primary aim of developing a method for assessing the risk of adverse cardiovascular events in patients with coronary artery disease (CAD) and chronic heart failure (CHF) who have undergone coronary artery bypass grafting (CABG), taking into account preoperative growth differentiation factor-15 (GDF-15) levels.
Material and Methods. This is a multicenter, observational, prospective study of the clinical course and outcomes of patients with CAD and CHF who have undergone CABG. To ensure a representative sample, at least 160 patients will be enrolled. The study will have a 12-month follow-up period.
Expected results. The study will include collecting patient complaints and anamnesis, performing a physical examination, a six minute walk test, and analyzing the results of general clinical laboratory and instrumental examinations. GDF-15 concentrations will be analyzed centrally at the Cardiology Research Institute, Tomsk NRMC laboratory. Treatment adherence will be assessed using the Morisky-Green questionnaire at the enrollment visit and after 12 months of follow-up. The study will be followed for 12 months. Prospective follow-up will assess the development of a combined primary and secondary endpoint, including death and adverse cardiovascular events.
Conclusion. PROFILE-HF is the first multicenter prospective study specifically designed to evaluate the prognostic significance of preoperative GDF-15 concentrations in patients with coronary artery disease and CHF who underwent CABG.
Keywords
About the Authors
A. A. GarganeevaRussian Federation
Alla A. Garganeeva, Dr. Sci. (Med.), Professor, Head of the Department of Myocardial Pathology, Cardiology Research Institute
111a, Kievskaya str., Tomsk, 634012, Russian Federation
E. A. Kuzheleva
Russian Federation
Elena A. Kuzheleva, Cand. Sci. (Med.), Senior Research Scientist, Department of Myocardial Pathology, Cardiology Research Institute
111a, Kievskaya str., Tomsk, 634012, Russian Federation
O. V. Tukish
Russian Federation
Olga V. Tukish, Cand. Sci. (Med.), Research Scientist, Department of Myocardial Pathology, Cardiology Research Institute
111a, Kievskaya str., Tomsk, 634012, Russian Federation
S. L. Andreev
Russian Federation
Sergey L. Andreev, Cand. Sci. (Med.), Research Scientist, Cardiovascular Surgery Department, Cardiology Research Institute
111a, Kievskaya str., Tomsk, 634012, Russian Federation
M. Yu. Kondratiev
Russian Federation
Mikhail Yu. Kondratiev, Research Scientist, Department of Myocardial Pathology, Cardiology Research Institute
111a, Kievskaya str., Tomsk, 634012, Russian Federation
E. E. Syromyatnikova
Russian Federation
Ekaterina E. Syromyatnikova, Laboratory Researcher, Department of Myocardial Pathology, Cardiology Research Institute
111a, Kievskaya str., Tomsk, 634012, Russian Federation
O. N. Ogurkova
Russian Federation
Oksana N. Ogurkova, Cand. Sci. (Med.), Research Scientist, Department of Department of Clinical and Laboratory Diagnostics, Cardiology Research Institute
111a, Kievskaya str., Tomsk, 634012, Russian Federation
A. E. Soloveva
Russian Federation
Anzhela E. Soloveva, Cand. Sci. (Med.), Associate Professor, Department of Hospital Therapy No. 2, N.V. Sklifosovsky Institute of Clinical Medicine
8, bldg. 2 Trubetskaya str., Moscow, 119048, Russian Federation
A. A. Shchendrygina
Russian Federation
Anastasia A. Shchendrygina, Cand. Sci. (Med.), Associate Professor, Department of Cardiology
8, bldg. 2 Trubetskaya str., Moscow, 119048, Russian Federation
I. A. Dyachuk
Russian Federation
Irina A. Dyachuk, Cardiology Department
4, Kolomensky Proyezd, Moscow, 115446, Russian Federation
A. N. Baglikov
Russian Federation
Andrey N. Baglikov, Cand. Sci. (Med.), Associate Professor
26, Stepana Razina str., Kaluga, 248023, Russian Federation
N. I. Novitskii
Russian Federation
Nikolay I. Novitskii, Cand. Sci. (Med.), Associate Professor
26, Stepana Razina str., Kaluga, 248023, Russian Federation
V. A. Fediunina
Russian Federation
Vera A. Fediunina, Assistant, Department of Propedeutics of Internal Medicine
build. 7, Sovetskaya, Orenburg, 460014, Russian Federation
T. N. Zvereva
Russian Federation
Tatyana N. Zvereva, Cand. Sci. (Med.), Associate Professor, Head of the Scientific and Educational Department
6, Barbarash Boulevard, 6, Kemerovo, 650002, Russian Federation
N. Sh. Zagidullin
Russian Federation
Naufal Sh. Zagidullin, Dr. Sci. (Med.), Professor, Chair of the Department of Propaedeutics of Internal Diseases
3, Lenina str., Ufa, Republic of Bashkortostan, 450008, Russian Federation
N. R. Khasanov
Russian Federation
Niyaz R. Khasanov, Dr. Sci. (Med.), Professor, Head of the Department of Propedeutics of Internal Diseases named after Professor S.S. Zimnitsky
49, Butlerova str., Kazan, 420012, Volga Federal District, Republic of Tatarstan, Russian Federation
O. L. Barbarash
Russian Federation
Olga L. Barbarash, Dr. Sci. (Med.), Professor, Academician of the Russian Academy of Sciences, Director
6, Barbarash Boulevard, 6, Kemerovo, 650002, Russian Federation
S. V. Popov
Russian Federation
Sergey V. Popov, Dr. Sci. (Med.), Professor, Academician of the Russian Academy of Sciences, Director
111a, Kievskaya str., Tomsk, 634012, Russian Federation
References
1. Polyakov D.S., Fomin I.V., Belenkov Y.N., et al. Chronic heart failure in the Russian Federation: what has changed over 20 years of follow-up? Results of the EPOCH-CHF study. Kardiologiia. 2021;61(4):4–14. (In Russ.). DOI: 10.18087/cardio.2021.4.n1628 EDN: WSZNFS
2. Shlyakhto E.V., Belenkov Yu.N., Boytsov S.A., et al. Characteristics and outcomes in outpatients with heart failure in Russia: results of a large-scale prospective observational multicenter registry study PRIORITY-HF. Russian Journal of Cardiology. 2025;30(11S):6516. (In Russ.). DOI: 10.15829/1560-4071-2025-6516. EDN: DZOXMG
3. Garganeeva A.A., Tukish O.V., Vitt K.N., et al. Chronic Heart Failure in Patients Hospitalized in 2002 and 2021: Comparative Analysis of Prevalence, Clinical Course and Drug Therapy. Kardiologiia. 2024;64(3):3–10. (In Russ.). DOI: 10.18087/cardio.2024.3.n2595 EDN: EWOGWO
4. Velazquez E.J., Lee K.L., Deja M.A., et al. STICH Investigators. Coronary-artery bypass surgery in patients with left ventricular dysfunction. N. Engl. J. Med. 2011;364(17):1607–1616. DOI: 10.1056/NEJMoa1100356
5. Marui A., Nishiwaki N., Komiya T., et al. CREDO-Kyoto CABG Registry Cohort-2 Investigators. Comparison of 5-Year Outcomes After Coronary Artery Bypass Grafting in Heart Failure Patients With Versus Without Preserved Left Ventricular Ejection Fraction (from the CREDO-Kyoto CABG Registry Cohort-2). Am. J. Cardiol. 2015;116(4):580–586. DOI: 10.1016/j.amjcard.2015.05.020
6. Ozdemir E., Stavileci B., Ozdemir B., et al. The association between growth differentiation factor 15 and presence and severity of coronary atherosclerosis. Adv. Med. Sci. 2024;69(1):56–60. DOI: 10.1016/j.advms.2024.02.003
7. Mourouzis K., Siasos G., Bozini N., et al. Association of Growth Differentiation Factor 15 with Arterial Stiffness and Endothelial Function in Subpopulations of Patients with Coronary Artery Disease: A Proof-of-Concept Study. Recent. Adv. Inflamm. Allergy Drug Discov. 2022;16(2):107–115. DOI: 10.2174/2772270817666221104120923
8. Alieva A.M., Reznik E.V., Pinchuk T.V., et al. Growth Differentiation Factor-15 (GDF-15) is a Biological Marker in Heart Failure. The Russian Archives of Internal Medicine. 2023;13(1):14–23. DOI: 10.20514/2226-6704-2023-13-1-14-23 EDN: DHDDPP
9. Zakharyan E.A. Interrelation of growth/differentiation factor-15 level with laboratory and clinical and functional parameters of patients with coronary artery disease. Cardiovascular Therapy and Prevention. 2023;22(5):3549. (In Russ.) DOI: 10.15829/1728-8800-2023-3549 EDN: XTIBWI
10. Kuzheleva E.A., Garganeeva A.A., Tukish O.V. Risk stratification of adverse cardiovascular events in patients with chronic heart failure and coronary artery disease undergoing surgical myocardial revascularization. Siberian Journal of Clinical and Experimental Medicine. 2026;41(1):149–160. (In Russ.) DOI: 10.29001/2073-8552-2026-41-1-149-160 EDN: KTHACD
11. Anand I.S., Kempf T., Rector T.S., et al. Serial measurement of growth-differentiation factor-15 in heart failure: relation to disease severity and prognosis in the Valsartan Heart Failure Trial. Circulation. 2010;122(14):1387–1395. DOI: 10.1161/CIRCULATIONAHA.109.928846
12. Bouabdallaoui N., Claggett B., Zile M.R., et al. PARADIGM-HF Investigators and Committees. Growth differentiation factor-15 is not modified by sacubitril/valsartan and is an independent marker of risk in patients with heart failure and reduced ejection fraction: the PARADIGM-HF trial. Eur. J. Heart Fail. 2018;20(12):1701–1709. DOI: 10.1002/ejhf.1301
13. Collet J.P., Thiele H., Barbato E., et al. ESC Scientific Document Group. 2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Eur. Heart J. 2024;45(5):404–405. DOI: 10.1093/eurheartj/ehad879
14. Wollert K.C., Kempf T., Peter T., et al. Prognostic value of growth-differentiation factor-15 in patients with non-ST-elevation acute coronary syndrome. Circulation. 2007;115(8):962–71. DOI: 10.1161/CIRCULATIONAHA.106.650846
15. Garganeeva A., Kuzheleva E., Tukish O., et al. Predictors of Adverse Cardiovascular Events After CABG in Patients with Previous Heart Failure. Life (Basel). 2025;15(3):387. DOI: 10.3390/life15030387
16. Baek S.J., Kim K.S., Nixon J.B., et al. Cyclooxygenase inhibitors regulate the expression of a TGF-beta superfamily member that has proapoptotic and antitumorigenic activities. Mol. Pharmacol. 2001;59(4):901–908. DOI: 10.1016/S0026-895X(24)09260-5
17. Silva-Bermudez L.S., Klüter H., Kzhyshkowska J.G. Macrophages as a Source and Target of GDF-15. Int. J. Mol. Sci. 2024;25(13):7313. DOI: 10.3390/ijms25137313
18. Groarke J.D., Crawford J., Collins S.M., et al. Ponsegromab for the Treatment of Cancer Cachexia. N. Engl. J. Med. 2024;391(24):2291–2303. DOI: 10.1056/NEJMoa2409515
Review
For citations:
Garganeeva A.A., Kuzheleva E.A., Tukish O.V., Andreev S.L., Kondratiev M.Yu., Syromyatnikova E.E., Ogurkova O.N., Soloveva A.E., Shchendrygina A.A., Dyachuk I.A., Baglikov A.N., Novitskii N.I., Fediunina V.A., Zvereva T.N., Zagidullin N.Sh., Khasanov N.R., Barbarash O.L., Popov S.V. Risk stratification of major adverse cardiovascular events in heart failure patients undergoing coronary artery bypass grafting: an observational multicenter prospective study (PROFILE-HF). Siberian Journal of Clinical and Experimental Medicine. (In Russ.) https://doi.org/10.29001/2073-8552-2026-3125
JATS XML

.png)
.png)
























