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 H...
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| Veröffentlicht in: | Clinical research in cardiology 2020-03, Vol.109 (3), p.331-338 |
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| creator | Santema, Bernadet T. Chan, Michelle M. Y. Tromp, Jasper Dokter, Martin van der Wal, Haye H. Emmens, Johanna E. Takens, Janny Samani, Nilesh J. Ng, Leong L. Lang, Chim C. van der Meer, Peter ter Maaten, Jozine M. Damman, Kevin Dickstein, Kenneth Cleland, John G. Zannad, Faiez Anker, Stefan D. Metra, Marco van der Harst, Pim de Boer, Rudolf A. van Veldhuisen, Dirk J. Rienstra, Michiel Lam, Carolyn S. P. Voors, Adriaan A. |
| description | 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
|
| doi_str_mv | 10.1007/s00392-019-01513-y |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7042190</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2251105659</sourcerecordid><originalsourceid>FETCH-LOGICAL-c508t-7017517a61ef986a8674417bc0de63b7a1acb9b8d0e68edafc055965de3b71403</originalsourceid><addsrcrecordid>eNp9kU1v1DAQhiMEoh_wBzggS1zoITBjx058QWoLbZFWhcNytpxk0rjKJoudLNp_j0PKAj0g2bLleead8bxJ8grhHQLk7wOA0DwF1HFLFOn-SXKMhcIUlOZPD_ciO0pOQrgHkAgie54cCeRKaK2Ok27dEnN9003UV8SGhtnRO9uxxpXedZ0d3dCzuMbIdbSjLszQ7Trd-uHi9ivbkQ9TYNcfr1KUUYltYwr1Y2A_3NiylqwfWWNdN3l6kTxrbBfo5cN5mny7-rS-vElXX64_X56v0kpCMaY5YC4xtwqp0YWyhcqzDPOygpqUKHOLtip1WdRAqqDaNhVIqZWsKQYxA3GafFh0t1O5obqK7Xjbma13G-v3ZrDO_BvpXWvuhp3JIeOoZ4GzRaB9lHZzvjLzGwjgHHK-w8i-fSjmh-8ThdFsXKgojq6nYQqGc4kIUkkd0TeP0Pth8n0cxUyB4FkBWaT4QlV-CMFTc-gAwczGm8V4E403v4w3-5j0-u8vH1J-Ox0BsQAhhvo78n9q_0f2JxrvuIA</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2250324804</pqid></control><display><type>article</type><title>The influence of atrial fibrillation on the levels of NT-proBNP versus GDF-15 in patients with heart failure</title><source>SpringerLink Journals - AutoHoldings</source><creator>Santema, Bernadet T. ; Chan, Michelle M. Y. ; Tromp, Jasper ; Dokter, Martin ; van der Wal, Haye H. ; Emmens, Johanna E. ; Takens, Janny ; Samani, Nilesh J. ; Ng, Leong L. ; Lang, Chim C. ; van der Meer, Peter ; ter Maaten, Jozine M. ; Damman, Kevin ; Dickstein, Kenneth ; Cleland, John G. ; Zannad, Faiez ; Anker, Stefan D. ; Metra, Marco ; van der Harst, Pim ; de Boer, Rudolf A. ; van Veldhuisen, Dirk J. ; Rienstra, Michiel ; Lam, Carolyn S. P. ; Voors, Adriaan A.</creator><creatorcontrib>Santema, Bernadet T. ; Chan, Michelle M. Y. ; Tromp, Jasper ; Dokter, Martin ; van der Wal, Haye H. ; Emmens, Johanna E. ; Takens, Janny ; Samani, Nilesh J. ; Ng, Leong L. ; Lang, Chim C. ; van der Meer, Peter ; ter Maaten, Jozine M. ; Damman, Kevin ; Dickstein, Kenneth ; Cleland, John G. ; Zannad, Faiez ; Anker, Stefan D. ; Metra, Marco ; van der Harst, Pim ; de Boer, Rudolf A. ; van Veldhuisen, Dirk J. ; Rienstra, Michiel ; Lam, Carolyn S. P. ; Voors, Adriaan A.</creatorcontrib><description>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.
Graphic abstract</description><identifier>ISSN: 1861-0684</identifier><identifier>EISSN: 1861-0692</identifier><identifier>DOI: 10.1007/s00392-019-01513-y</identifier><identifier>PMID: 31263996</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Aged ; Aged, 80 and over ; Atrial Fibrillation ; Biomarkers ; Cardiac arrhythmia ; Cardiology ; Cardiology and cardiovascular system ; Cohort Studies ; Congestive heart failure ; Female ; Fibrillation ; Growth Differentiation Factor 15 ; Heart Failure ; Human health and pathology ; Humans ; Life Sciences ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Natriuretic Peptide, Brain ; Original Paper ; Peptide Fragments ; Plasma levels ; Prospective Studies</subject><ispartof>Clinical research in cardiology, 2020-03, Vol.109 (3), p.331-338</ispartof><rights>The Author(s) 2019</rights><rights>Clinical Research in Cardiology is a copyright of Springer, (2019). All Rights Reserved. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Attribution</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c508t-7017517a61ef986a8674417bc0de63b7a1acb9b8d0e68edafc055965de3b71403</citedby><cites>FETCH-LOGICAL-c508t-7017517a61ef986a8674417bc0de63b7a1acb9b8d0e68edafc055965de3b71403</cites><orcidid>0000-0002-5417-4415 ; 0000-0002-2581-070X ; 0000-0001-6691-8568</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00392-019-01513-y$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00392-019-01513-y$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,780,784,885,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31263996$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://hal.univ-lorraine.fr/hal-03022072$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Santema, Bernadet T.</creatorcontrib><creatorcontrib>Chan, Michelle M. Y.</creatorcontrib><creatorcontrib>Tromp, Jasper</creatorcontrib><creatorcontrib>Dokter, Martin</creatorcontrib><creatorcontrib>van der Wal, Haye H.</creatorcontrib><creatorcontrib>Emmens, Johanna E.</creatorcontrib><creatorcontrib>Takens, Janny</creatorcontrib><creatorcontrib>Samani, Nilesh J.</creatorcontrib><creatorcontrib>Ng, Leong L.</creatorcontrib><creatorcontrib>Lang, Chim C.</creatorcontrib><creatorcontrib>van der Meer, Peter</creatorcontrib><creatorcontrib>ter Maaten, Jozine M.</creatorcontrib><creatorcontrib>Damman, Kevin</creatorcontrib><creatorcontrib>Dickstein, Kenneth</creatorcontrib><creatorcontrib>Cleland, John G.</creatorcontrib><creatorcontrib>Zannad, Faiez</creatorcontrib><creatorcontrib>Anker, Stefan D.</creatorcontrib><creatorcontrib>Metra, Marco</creatorcontrib><creatorcontrib>van der Harst, Pim</creatorcontrib><creatorcontrib>de Boer, Rudolf A.</creatorcontrib><creatorcontrib>van Veldhuisen, Dirk J.</creatorcontrib><creatorcontrib>Rienstra, Michiel</creatorcontrib><creatorcontrib>Lam, Carolyn S. P.</creatorcontrib><creatorcontrib>Voors, Adriaan A.</creatorcontrib><title>The influence of atrial fibrillation on the levels of NT-proBNP versus GDF-15 in patients with heart failure</title><title>Clinical research in cardiology</title><addtitle>Clin Res Cardiol</addtitle><addtitle>Clin Res Cardiol</addtitle><description>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.
Graphic abstract</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Atrial Fibrillation</subject><subject>Biomarkers</subject><subject>Cardiac arrhythmia</subject><subject>Cardiology</subject><subject>Cardiology and cardiovascular system</subject><subject>Cohort Studies</subject><subject>Congestive heart failure</subject><subject>Female</subject><subject>Fibrillation</subject><subject>Growth Differentiation Factor 15</subject><subject>Heart Failure</subject><subject>Human health and pathology</subject><subject>Humans</subject><subject>Life Sciences</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Natriuretic Peptide, Brain</subject><subject>Original Paper</subject><subject>Peptide Fragments</subject><subject>Plasma levels</subject><subject>Prospective Studies</subject><issn>1861-0684</issn><issn>1861-0692</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kU1v1DAQhiMEoh_wBzggS1zoITBjx058QWoLbZFWhcNytpxk0rjKJoudLNp_j0PKAj0g2bLleead8bxJ8grhHQLk7wOA0DwF1HFLFOn-SXKMhcIUlOZPD_ciO0pOQrgHkAgie54cCeRKaK2Ok27dEnN9003UV8SGhtnRO9uxxpXedZ0d3dCzuMbIdbSjLszQ7Trd-uHi9ivbkQ9TYNcfr1KUUYltYwr1Y2A_3NiylqwfWWNdN3l6kTxrbBfo5cN5mny7-rS-vElXX64_X56v0kpCMaY5YC4xtwqp0YWyhcqzDPOygpqUKHOLtip1WdRAqqDaNhVIqZWsKQYxA3GafFh0t1O5obqK7Xjbma13G-v3ZrDO_BvpXWvuhp3JIeOoZ4GzRaB9lHZzvjLzGwjgHHK-w8i-fSjmh-8ThdFsXKgojq6nYQqGc4kIUkkd0TeP0Pth8n0cxUyB4FkBWaT4QlV-CMFTc-gAwczGm8V4E403v4w3-5j0-u8vH1J-Ox0BsQAhhvo78n9q_0f2JxrvuIA</recordid><startdate>20200301</startdate><enddate>20200301</enddate><creator>Santema, Bernadet T.</creator><creator>Chan, Michelle M. Y.</creator><creator>Tromp, Jasper</creator><creator>Dokter, Martin</creator><creator>van der Wal, Haye H.</creator><creator>Emmens, Johanna E.</creator><creator>Takens, Janny</creator><creator>Samani, Nilesh J.</creator><creator>Ng, Leong L.</creator><creator>Lang, Chim C.</creator><creator>van der Meer, Peter</creator><creator>ter Maaten, Jozine M.</creator><creator>Damman, Kevin</creator><creator>Dickstein, Kenneth</creator><creator>Cleland, John G.</creator><creator>Zannad, Faiez</creator><creator>Anker, Stefan D.</creator><creator>Metra, Marco</creator><creator>van der Harst, Pim</creator><creator>de Boer, Rudolf A.</creator><creator>van Veldhuisen, Dirk J.</creator><creator>Rienstra, Michiel</creator><creator>Lam, Carolyn S. P.</creator><creator>Voors, Adriaan A.</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><general>Springer Verlag</general><scope>C6C</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M7Z</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>1XC</scope><scope>VOOES</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-5417-4415</orcidid><orcidid>https://orcid.org/0000-0002-2581-070X</orcidid><orcidid>https://orcid.org/0000-0001-6691-8568</orcidid></search><sort><creationdate>20200301</creationdate><title>The influence of atrial fibrillation on the levels of NT-proBNP versus GDF-15 in patients with heart failure</title><author>Santema, Bernadet T. ; Chan, Michelle M. Y. ; Tromp, Jasper ; Dokter, Martin ; van der Wal, Haye H. ; Emmens, Johanna E. ; Takens, Janny ; Samani, Nilesh J. ; Ng, Leong L. ; Lang, Chim C. ; van der Meer, Peter ; ter Maaten, Jozine M. ; Damman, Kevin ; Dickstein, Kenneth ; Cleland, John G. ; Zannad, Faiez ; Anker, Stefan D. ; Metra, Marco ; van der Harst, Pim ; de Boer, Rudolf A. ; van Veldhuisen, Dirk J. ; Rienstra, Michiel ; Lam, Carolyn S. P. ; Voors, Adriaan A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c508t-7017517a61ef986a8674417bc0de63b7a1acb9b8d0e68edafc055965de3b71403</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Atrial Fibrillation</topic><topic>Biomarkers</topic><topic>Cardiac arrhythmia</topic><topic>Cardiology</topic><topic>Cardiology and cardiovascular system</topic><topic>Cohort Studies</topic><topic>Congestive heart failure</topic><topic>Female</topic><topic>Fibrillation</topic><topic>Growth Differentiation Factor 15</topic><topic>Heart Failure</topic><topic>Human health and pathology</topic><topic>Humans</topic><topic>Life Sciences</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Natriuretic Peptide, Brain</topic><topic>Original Paper</topic><topic>Peptide Fragments</topic><topic>Plasma levels</topic><topic>Prospective Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Santema, Bernadet T.</creatorcontrib><creatorcontrib>Chan, Michelle M. Y.</creatorcontrib><creatorcontrib>Tromp, Jasper</creatorcontrib><creatorcontrib>Dokter, Martin</creatorcontrib><creatorcontrib>van der Wal, Haye H.</creatorcontrib><creatorcontrib>Emmens, Johanna E.</creatorcontrib><creatorcontrib>Takens, Janny</creatorcontrib><creatorcontrib>Samani, Nilesh J.</creatorcontrib><creatorcontrib>Ng, Leong L.</creatorcontrib><creatorcontrib>Lang, Chim C.</creatorcontrib><creatorcontrib>van der Meer, Peter</creatorcontrib><creatorcontrib>ter Maaten, Jozine M.</creatorcontrib><creatorcontrib>Damman, Kevin</creatorcontrib><creatorcontrib>Dickstein, Kenneth</creatorcontrib><creatorcontrib>Cleland, John G.</creatorcontrib><creatorcontrib>Zannad, Faiez</creatorcontrib><creatorcontrib>Anker, Stefan D.</creatorcontrib><creatorcontrib>Metra, Marco</creatorcontrib><creatorcontrib>van der Harst, Pim</creatorcontrib><creatorcontrib>de Boer, Rudolf A.</creatorcontrib><creatorcontrib>van Veldhuisen, Dirk J.</creatorcontrib><creatorcontrib>Rienstra, Michiel</creatorcontrib><creatorcontrib>Lam, Carolyn S. P.</creatorcontrib><creatorcontrib>Voors, Adriaan A.</creatorcontrib><collection>Springer Nature OA/Free Journals</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biochemistry Abstracts 1</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>Hyper Article en Ligne (HAL)</collection><collection>Hyper Article en Ligne (HAL) (Open Access)</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Clinical research in cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Santema, Bernadet T.</au><au>Chan, Michelle M. Y.</au><au>Tromp, Jasper</au><au>Dokter, Martin</au><au>van der Wal, Haye H.</au><au>Emmens, Johanna E.</au><au>Takens, Janny</au><au>Samani, Nilesh J.</au><au>Ng, Leong L.</au><au>Lang, Chim C.</au><au>van der Meer, Peter</au><au>ter Maaten, Jozine M.</au><au>Damman, Kevin</au><au>Dickstein, Kenneth</au><au>Cleland, John G.</au><au>Zannad, Faiez</au><au>Anker, Stefan D.</au><au>Metra, Marco</au><au>van der Harst, Pim</au><au>de Boer, Rudolf A.</au><au>van Veldhuisen, Dirk J.</au><au>Rienstra, Michiel</au><au>Lam, Carolyn S. P.</au><au>Voors, Adriaan A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The influence of atrial fibrillation on the levels of NT-proBNP versus GDF-15 in patients with heart failure</atitle><jtitle>Clinical research in cardiology</jtitle><stitle>Clin Res Cardiol</stitle><addtitle>Clin Res Cardiol</addtitle><date>2020-03-01</date><risdate>2020</risdate><volume>109</volume><issue>3</issue><spage>331</spage><epage>338</epage><pages>331-338</pages><issn>1861-0684</issn><eissn>1861-0692</eissn><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
< 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.
Graphic abstract</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>31263996</pmid><doi>10.1007/s00392-019-01513-y</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-5417-4415</orcidid><orcidid>https://orcid.org/0000-0002-2581-070X</orcidid><orcidid>https://orcid.org/0000-0001-6691-8568</orcidid><oa>free_for_read</oa></addata></record> |
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| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7042190 |
| source | SpringerLink Journals - AutoHoldings |
| subjects | Aged Aged, 80 and over Atrial Fibrillation Biomarkers Cardiac arrhythmia Cardiology Cardiology and cardiovascular system Cohort Studies Congestive heart failure Female Fibrillation Growth Differentiation Factor 15 Heart Failure Human health and pathology Humans Life Sciences Male Medicine Medicine & Public Health Middle Aged Natriuretic Peptide, Brain Original Paper Peptide Fragments Plasma levels Prospective Studies |
| title | The influence of atrial fibrillation on the levels of NT-proBNP versus GDF-15 in patients with heart failure |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-21T08%3A30%3A59IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=The%20influence%20of%20atrial%20fibrillation%20on%20the%20levels%20of%20NT-proBNP%20versus%20GDF-15%20in%20patients%20with%20heart%20failure&rft.jtitle=Clinical%20research%20in%20cardiology&rft.au=Santema,%20Bernadet%20T.&rft.date=2020-03-01&rft.volume=109&rft.issue=3&rft.spage=331&rft.epage=338&rft.pages=331-338&rft.issn=1861-0684&rft.eissn=1861-0692&rft_id=info:doi/10.1007/s00392-019-01513-y&rft_dat=%3Cproquest_pubme%3E2251105659%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2250324804&rft_id=info:pmid/31263996&rfr_iscdi=true |