title: Cardiac Remodeling, Circulating Biomarkers and Clinical Events in Patients with a History of Atrial Fibrillation. Data from the GISSI-AF Trial.
abstract: OBJECTIVE
  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.affiliation: IRCCS-Istituto di Ricerche Farmacologiche "MarioNegri", Via Giuseppe La Masa, 19, 20156, Milan, Italy. lidia.staszewsky@marionegri.it.
authors.forename: Lidia
authors.initials: L
authors.lastname: Staszewsky
authors.affiliation: IRCCS-Istituto di Ricerche Farmacologiche "MarioNegri", Via Giuseppe La Masa, 19, 20156, Milan, Italy.
authors.forename: Serge
authors.initials: S
authors.lastname: Masson
authors.affiliation: IRCCS-Istituto di Ricerche Farmacologiche "MarioNegri", Via Giuseppe La Masa, 19, 20156, Milan, Italy.
authors.forename: Simona
authors.initials: S
authors.lastname: Barlera
authors.affiliation: Ospedale Santa Chiara, Trento, Italy.
authors.forename: Marcello
authors.initials: M
authors.lastname: Disertori
authors.affiliation: Ospedale Civile San Biagio, Bovolone, Verona, Italy.
authors.forename: Silvana
authors.initials: S
authors.lastname: Boni
authors.affiliation: Ospedale San Bartolomeo U.O, Santa Caterina, Sarzana, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Bertoli
authors.affiliation: Ospedale San Antonio, San Daniele del Friuli, Italy.
authors.forename: Olga
authors.initials: O
authors.lastname: Vriz
authors.affiliation: Cardiocentro Ticino, Lugano, Switzerland.
authors.forename: Elena
authors.initials: E
authors.lastname: Pasotti
authors.affiliation: Ospedale Santa Chiara, Trento, Italy.
authors.forename: Prisca
authors.initials: P
authors.lastname: Zeni
authors.affiliation: Ospedale Luigi Sacco, Milan, Italy.
authors.forename: Tarcisio
authors.initials: T
authors.lastname: Vago
authors.affiliation: ANMCO Research Center, Florence, Italy.
authors.forename: Aldo P
authors.initials: AP
authors.lastname: Maggioni
authors.affiliation: IRCCS-Istituto di Ricerche Farmacologiche "MarioNegri", Via Giuseppe La Masa, 19, 20156, Milan, Italy.
authors.forename: Gianni
authors.initials: G
authors.lastname: Tognoni
authors.affiliation: IRCCS-Istituto di Ricerche Farmacologiche "MarioNegri", Via Giuseppe La Masa, 19, 20156, Milan, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Latini
keywords: Atrial fibrillation; Atrial fibrillation recurrence; Circulating biomarkers; Clinical trial; Echocardiography; Hospitalizations; Natriuretic peptides