Lidia Staszewsky1, Serge Masson2, Simona Barlera2, Marcello Disertori3, Silvana Boni4, Daniele Bertoli5, Olga Vriz6, Elena Pasotti7, Prisca Zeni3, Tarcisio Vago8, Aldo P Maggioni9, Gianni Tognoni2, Roberto Latini2. 1. IRCCS-Istituto di Ricerche Farmacologiche "MarioNegri", Via Giuseppe La Masa, 19, 20156, Milan, Italy. lidia.staszewsky@marionegri.it. 2. IRCCS-Istituto di Ricerche Farmacologiche "MarioNegri", Via Giuseppe La Masa, 19, 20156, Milan, Italy. 3. Ospedale Santa Chiara, Trento, Italy. 4. Ospedale Civile San Biagio, Bovolone, Verona, Italy. 5. Ospedale San Bartolomeo U.O, Santa Caterina, Sarzana, Italy. 6. Ospedale San Antonio, San Daniele del Friuli, Italy. 7. Cardiocentro Ticino, Lugano, Switzerland. 8. Ospedale Luigi Sacco, Milan, Italy. 9. ANMCO Research Center, Florence, Italy.
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.
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.
Authors: John H Rosenberg; John H Werner; Gilman D Plitt; Victoria V Noble; Jordan T Spring; Brooke A Stephens; Aleem Siddique; Helenmari L Merritt-Genore; Michael J Moulton; Devendra K Agrawal Journal: Expert Rev Cardiovasc Ther Date: 2018-12-29