The influence of atrial fibrillation on the levels of NT-proBNP versus GDF-15 in patients with heart failure
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ORIGINAL PAPER
The influence of atrial fibrillation on the levels of NT‑proBNP versus GDF‑15 in patients with heart failure Bernadet T. Santema1 · Michelle M. Y. Chan2 · Jasper Tromp1,2 · Martin Dokter1 · Haye H. van der Wal1 · Johanna E. Emmens1 · Janny Takens1 · Nilesh J. Samani3,4 · Leong L. Ng3,4 · Chim C. Lang5 · Peter van der Meer1 · Jozine M. ter Maaten1 · Kevin Damman1 · Kenneth Dickstein6,7 · John G. Cleland8,9 · Faiez Zannad10 · Stefan D. Anker11 · Marco Metra12 · Pim van der Harst1 · Rudolf A. de Boer1 · Dirk J. van Veldhuisen1 · Michiel Rienstra1 · Carolyn S. P. Lam1,2 · Adriaan A. Voors1 Received: 12 March 2019 / Accepted: 19 June 2019 © The Author(s) 2019
Abstract Background In heart failure (HF), levels of NT-proBNP are influenced by the presence of concomitant atrial fibrillation (AF), making it difficult to distinguish between HF versus AF in patients with raised NT-proBNP. It is unknown whether levels of GDF-15 are also influenced by AF in patients with HF. In this study we compared the plasma levels of NT-proBNP versus GDF-15 in patients with HF in AF versus sinus rhythm (SR). Methods In a post hoc analysis of the index cohort of BIOSTAT-CHF (n = 2516), we studied patients with HF categorized into three groups: (1) AF at baseline (n = 733), (2) SR at baseline with a history of AF (n = 183), and (3) SR at baseline and no history of AF (n = 1025). The findings were validated in the validation cohort of BIOSTAT-CHF (n = 1738). Results Plasma NT-proBNP levels of patients who had AF at baseline were higher than those of patients in SR (both with and without a history of AF), even after multivariable adjustment (3417 [25th–75th percentile 1897–6486] versus 1788 [682–3870], adjusted p
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