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Influence of the matrix type over the concentration of GDF-15
  1. José Miguel Rivera-Caravaca1,
  2. Juan Antonio Vílchez2,
  3. Carlos Rodríguez-Rojas2,
  4. María Dolores Albadalejo-Otón2,
  5. Pablo Gil-Pérez1,
  6. Cecilia Lopez-García1,
  7. Andrea Veliz-Martínez1,
  8. Vanessa Roldán3,
  9. Francisco Marín1
  1. 1Department of Cardiology, Hospital Clínico Universitario Virgen de la Arrixaca, University of Murcia, Instituto Murciano de Investigación Biosanitaria (IMIBArrixaca), CIBERCV, Murcia, Spain
  2. 2Department of Clinical Analysis, Hospital General Universitario Santa Lucía, Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), Cartagena, Spain
  3. 3Department of Hematology and Clinical Oncology, Hospital General Universitario Morales Meseguer, University of Murcia, Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), Murcia, Spain
  1. Correspondence to Dr Francisco Marín, Department of Cardiology, Hospital Clínico Universitario Virgen de la Arrixaca, Ctra. Madrid-Cartagena s/n 30120, Murcia, Spain; fcomarino{at}


Growth differentiation factor 15 (GDF-15) has been suggested as a prognostic biomarker for bleeding and mortality in atrial fibrillation (AF). To date, serum and EDTA matrices are standardized for the GDF-15 assay but it is unclear if it can be measured also in citrate. In this study, we aim to investigate if the Elecsys GDF-15 assay (Roche Diagnostics, Mannheim, Germany) can be determined accurately in citrate samples in a cohort of 10 patients with AF and 10 healthy controls. From January 2018 to March 2018, we included healthy controls and patients with AF under vitamin K antagonists in a tertiary hospital. Blood samples were drawn in both groups. We included 10 controls (50% males, mean age 36.4±8.9 years) and 10 patients with AF (80% males, mean age 76.5±16.6 years). The mean GDF-15 levels were increased in patients with AF in comparison to healthy controls, as expected by the presence of a heart-related condition and the higher age of this population. In healthy controls, GDF-15 levels showed an optimal correlation between EDTA-serum (r=0.975; p<0.001), EDTA-citrate (r=0.972; p<0.001), and serum-citrate (r=0.997; p<0.001) samples. This was also observed in patients with AF: EDTA-serum (r=0.975; p<0.001), serum-citrate (r=0.835; p=0.003), and EDTA-citrate (r=0.768; p=0.009). Our results demonstrate that citrate samples may be used for the determination of GDF-15 in AF given the positive and good correlation with EDTA and serum matrices. Further studies should validate these observations.

  • biomarkers
  • atrial fibrillation
  • GDF-15
  • serum
  • EDTA
  • citrate

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  • JMR-C and JAV are joint first authors.

  • Twitter @JosemyRivera

  • JMR-C and JAV contributed equally.

  • Contributors VR and FM designed the study and critically revised the manuscript. JMRC, JAV and FM performed statistical analysis and drafted the manuscript. JAV, CRR and MDAO analyzed blood samples. CLG, PGP and JMRC drew the blood samples and contributed to the acquisition of data for the work. PGP plotted the figures. All authors gave final approval.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The study protocol was approved by the Ethics Committee of Hospital Clínico Universitario Virgen de la Arrixaca (FMO-2018).

  • Provenance and peer review Not commissioned; externally peer reviewed.