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The influence of atrial fibrillation on the levels of NT-proBNP versus GDF-15 in patients with heart failure.

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  • Additional Information
    • Publication Information:
      Springer (part of Springer Nature) for German Cardiac Society
    • Publication Date:
      2019
    • Collection:
      University of Leicester: Leicester Research Archive (LRA)
    • Abstract:
      The online version of this article (https://doi.org/10.1007/s00392-019-01513-y) contains supplementary material, which is available to authorized users. ; 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 < 0.001, versus 2231 pg/mL [902-5270], adjusted p < 0.001). In contrast, after adjusting for clinical confounders, the levels of GDF-15 were comparable between the three groups (3179 [2062-5253] versus 2545 [1686-4337], adjusted p = 0.36, versus 2294 [1471-3855] pg/mL, adjusted p = 0.08). Similar patterns of both NT-proBNP and GDF-15 were found in the validation cohort. CONCLUSION: These data show that in patients with HF, NT-proBNP is significantly influenced by underlying AF at time of measurement and not by previous episodes of AF, whereas the levels of GDF-15 are not influenced by the presence of AF. Therefore, GDF-15 might have additive value combined with NT-proBNP in the assessment of patients with HF and concomitant AF. ; This work was supported by the Netherlands Cardiovascular Research Initiative: an initiative with ...
    • ISSN:
      1861-0692
    • Relation:
      https://www.ncbi.nlm.nih.gov/pubmed/31263996; Clinical Research in Cardiology, 2019; https://link.springer.com/article/10.1007%2Fs00392-019-01513-y; http://hdl.handle.net/2381/44780
    • Accession Number:
      10.1007/s00392-019-01513-y
    • Online Access:
      https://link.springer.com/article/10.1007%2Fs00392-019-01513-y
      http://hdl.handle.net/2381/44780
      https://doi.org/10.1007/s00392-019-01513-y
    • Rights:
      Copyright © the authors, 2019. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
    • Accession Number:
      edsbas.514FA8B6