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

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