在面对心血管疾病（CVDs）日益严峻和人口老龄化的世界中，心脏手术前精确的风险评估至关重要。尽管日本SCORE，胸外科医生学会评分和EuroSCORE II等传统的风险计算器已经被证明有效，但它们可能无法完全捕捉到当代风险，特别是由脆弱和肌萎缩等新出现的因素引起的风险。这些计算器通常关注地区和民族特异性，并且严重依赖基于年龄和潜在疾病的评估。生长分化因子-15（GDF-15）是一种应激反应的细胞因子，已被确定为肌萎缩的潜在生物标志物，并且是未来心脏风险评估的工具。手术前血浆GDF-15水平与接受心脏手术的患者的术前、术中和术后因素以及短期和长期死亡率有关。增加的血浆GDF-15水平具有预测意义，与手术中使用体外循环、出血量、术后急性肾损伤和重症监护病房停留时间有关。值得注意的是，将术前GDF-15水平纳入风险分层模型可以提高其预测价值，尤其是与脑钠肽N末端前体相比，后者不会导致重分类。因此，本研究审查了心脏手术传统风险评估和新生物标志物GDF-15的作用。本研究承认患者预后与升高的GDF-15水平之间的关系不仅限于心血管疾病或心脏手术，还可能与糖尿病和癌症等各种疾病有关。此外，GDF-15的正常范围尚未明确定义。鉴于GDF-15在改善心血管手术的患者护理和预后方面的潜力，未来的研究应探索GDF-15作为术后结果的生物标志物和靶向治疗干预的潜力。版权所有 © 2023. Elsevier Ltd.出版。

In a world increasingly confronted by cardiovascular diseases (CVDs) and an aging population, accurate risk assessment prior to cardiac surgery is critical. Although effective, traditional risk calculators such as the Japan SCORE, Society of Thoracic Surgeons score, and EuroSCORE II may not completely capture contemporary risks, particularly due to emerging factors such as frailty and sarcopenia. These calculators often focus on regional and ethnic specificity and rely heavily on evaluations based on age and underlying diseases. Growth differentiation factor-15 (GDF-15) is a stress-responsive cytokine that has been identified as a potential biomarker for sarcopenia and a tool for future cardiac risk assessment. Preoperative plasma GDF-15 levels have been associated with preoperative, intraoperative, and postoperative factors and short- and long-term mortality rates in patients undergoing cardiac surgery. Increased plasma GDF-15 levels have prognostic significance, having been correlated with the use of cardiopulmonary bypass during surgery, amount of bleeding, postoperative acute kidney injury, and intensive care unit stay duration. Notably, the inclusion of preoperative levels of GDF-15 in risk stratification models enhances their predictive value, especially when compared with those of the N-terminal prohormone of brain natriuretic peptide, which does not lead to reclassification. Thus, this review examines traditional risk assessments for cardiac surgery and the role of the novel biomarker GDF-15. This study acknowledges that the relationship between patient outcomes and elevated GDF-15 levels is not limited to CVDs or cardiac surgery but can be associated with variable diseases, including diabetes and cancer. Moreover, the normal range of GDF-15 is not well defined. Given its promise for improving patient care and outcomes in cardiovascular surgery, future research should explore the potential of GDF-15 as a biomarker for postoperative outcomes and target therapeutic intervention.Copyright © 2023. Published by Elsevier Ltd.