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Cardiac Remodeling, Circulating Biomarkers and Clinical Events in Patients with a History of Atrial Fibrillation. Data from the GISSI-AF Trial

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Abstract

Purpose

Atrial fibrillation (AF) is the most common arrhythmia and has an increasing impact on public health because of its morbidity and mortality. Clinical and diagnostic tests to predict the recurrence of arrhythmia and clinical events before AF becomes permanent are still an open issue.

Methods

307 out of 1442 patients in sinus rhythm, at high risk of recurrence of AF enrolled in the GISSI-AF study, participated in a substudy with echocardiographic and biohumoral evaluation at baseline and at 12-month follow-up. The relations between biomarker concentrations and echocardiographic parameters with study endpoints in 1 year, were analysed by a stepwise multivariable Cox model (entry criteria p < 0.5 and stay criteria p < 0.2).

Results

The echocardiographic variables, cardiac markers and clinical variables considered in the statistical model indicated a higher concentration of NT-proBNP at baseline as the strongest factor related to time of first AF recurrence (HR 1.42; 95 %CI 1.23–1.46), first CV hospitalization (HR 1.58; 95 %CI 1.31–1.92) and increasing duration of recurrent AF (OR 2.16; 95 %CI 1.52–3.08). Valsartan treatment was not related to clinical events.

Conclusions

In patients in sinus rhythm with a history of AF a higher concentration of NT-proBNP at baseline was the strongest independent risk factor for first AF recurrence and its duration, and for the first hospital admission for cardiovascular reasons.

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Acknowledgments

We thank the patients, nurses and cardiologists who participated in the echocardiographic and biohumoral substudy of GISSI-AF. We are grateful to J.D. Baggott for language editing.

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Authors and Affiliations

  1. IRCCS-Istituto di Ricerche Farmacologiche “MarioNegri”, Via Giuseppe La Masa, 19, 20156, Milan, Italy

    Lidia Staszewsky, Serge Masson, Simona Barlera, Gianni Tognoni & Roberto Latini

  2. Ospedale Santa Chiara, Trento, Italy

    Marcello Disertori & Prisca Zeni

  3. Ospedale Civile San Biagio, Bovolone, Verona, Italy

    Silvana Boni

  4. Ospedale San Bartolomeo U.O, Santa Caterina, Sarzana, Italy

    Daniele Bertoli

  5. Ospedale San Antonio, San Daniele del Friuli, Italy

    Olga Vriz

  6. Cardiocentro Ticino, Lugano, Switzerland

    Elena Pasotti

  7. Ospedale Luigi Sacco, Milan, Italy

    Tarcisio Vago

  8. ANMCO Research Center, Florence, Italy

    Aldo P. Maggioni

Authors
  1. Lidia Staszewsky
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  2. Serge Masson
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  3. Simona Barlera
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  4. Marcello Disertori
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  5. Silvana Boni
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  6. Daniele Bertoli
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  7. Olga Vriz
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  8. Elena Pasotti
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  9. Prisca Zeni
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  10. Tarcisio Vago
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  11. Aldo P. Maggioni
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  12. Gianni Tognoni
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  13. Roberto Latini
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on the behalf of the GISSI-AF Investigators

Corresponding author

Correspondence to Lidia Staszewsky.

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Funding sources

The GISSI Studies and this substudy are supported by Associazione Nazionale Medici Cardiologi Ospedalieri and by IRCCS-Istituto di Ricerche Farmacologiche “Mario Negri”. Funding was provided by Novartis, which had no role in the design or conduction of the trial, the collection, analysis, or interpretation of the data; or the writing of the report. Reagents for measuring circulating biomarkers were kindly provided by B.R.A.H.M.S. AG and Roche Diagnostics GmbH.

Conflict of interests and disclosures

Drs. Masson, Staszewsky, Maggioni, Disertori and Latini received institutional research support from Novartis Pharma, the company that funded the GISSI-AF trial.

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Staszewsky, L., Masson, S., Barlera, S. et al. Cardiac Remodeling, Circulating Biomarkers and Clinical Events in Patients with a History of Atrial Fibrillation. Data from the GISSI-AF Trial. Cardiovasc Drugs Ther 29, 551–561 (2015). https://doi.org/10.1007/s10557-015-6624-3

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  • DOI: https://doi.org/10.1007/s10557-015-6624-3

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