Atrial Fibrillation in Relationship to Plasma Biomarkers (AFISBIO II)
The general objective of this study is to:
A. To identify novel plasmatic biomarkers associated with prevalent/incident atrial fibrillation in patients with high risk for AF and stroke.
B. To assess predictive ability of novel plasmatic biomarkers (especially apelin and miRNAs) on prevalent/incident atrial fibrillation in patients with high risk for AF and stroke.
C. To validate predictive models from previous studies based on comorbidities, age, sex, BMI, NT-proBNP, FGF-23, IGF-1 and IGFBP-1 on prevalent/incident AF in patients with high risk for AF and stroke.
調査の概要
状態
条件
詳細な説明
Atrial fibrillation (AF) is the most common sustained arrhythmia, associated with an increased risk of stroke, heart failure, and mortality. Despite the high prevalence, AF may be asymptomatic and consequently unrecognized. Detection of asymptomatic AF is challenging as only a minority of the patients is diagnosed during standard examinations with a 12 - lead ECG or a 24h ECG Holter monitoring. Furthermore, prolonged ECG monitoring is costly and can be inconvenient for the patients. Documented AF causes 15% of ischemic strokes. However, approximately 25% of ischemic strokes is of an unknown etiology. It is believed that undetected asymptomatic AF is responsible for some of these strokes.
Plasmatic biomarkers might be of importance in the early diagnosis of AF. Several plasmatic biomarkers have been studied in order to find an association with AF. Cardiac biomarkers such as natriuretic peptides and high-sensitivity troponins are increased in patients with AF. A novel biomarker that is depending on left atrial stretching and ionotropic effects is apelin. In our previous research we discovered that apelin is associated with AF, negatively correlates with AF burden, but only in patients without reduced LVEF. Similarly, parameters reflecting thrombogenesis, such as Fibrinogen and fibrin D-dimer were also found to be associated with the arrhythmia. Other protein biomarkers have been studied in relation to AF incidence. Insulin-like growth factor-binding protein 1 (IGFBP-1) and Insulin-like growth factor 1 (IGF-1) have shown an association with higher risk of incident AF. Previous research also indicated Fibroblast growth factor 23 (FGF-23) to be associated with AF.
However, biomarkers, such as the inflammatory markers high-sensitivity CRP have shown conflicting results.
Finally, in the last years, circulating microRNAs emerged as a promising biomarker of AF, having important function in suppression of messenger RNA responsible for electric and structural remodeling of the left atria.
In our previous case-matched study we discovered that selected miRNAs were associated with paroxysmal AF.
研究の種類
入学 (予想される)
連絡先と場所
研究連絡先
- 名前:Allan Böhm, MD, PhD, MBA, FESC
- 電話番号:+421 907 411 499
- メール:allan.bohm@gmail.com
研究場所
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Bratislava、スロバキア、813 69
- 募集
- University Hospital Bratislava - Old Town Hospital
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コンタクト:
- Martin Čaprnda, MD, PhD
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主任研究者:
- Martin Čaprnda, MD, PhD
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Bratislava、スロバキア、826 06
- 募集
- University Hospital Bratislava - Hospital Ruzinov
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コンタクト:
- Ján Páleš, MD
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主任研究者:
- Ján Páleš, MD
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Bratislava、スロバキア、833 05
- 募集
- University Hospital Bratislava - Hospital of the Academician Ladislav Dérer
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コンタクト:
- Tereza Hlavatá, MD
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主任研究者:
- Tereza Hlavatá, MD
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Bratislava、スロバキア、833 48
- 募集
- National Institute for Cardiovascular Diseases
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コンタクト:
- Allan Böhm, PhD, MBA, FESC
- 電話番号:+421 907 411 499
- メール:allan.bohm@gmail.com
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主任研究者:
- Allan Böhm, PhD, MBA, FESC
-
Malacky、スロバキア
- 募集
- Hospital Malacky
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コンタクト:
- Tomáš Uher, MD
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主任研究者:
- Tomáš Uher, MD
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Nitra、スロバキア、950 01
- 募集
- Faculty Hospital Nitra
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コンタクト:
- Peter Snopek, MD
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主任研究者:
- Peter Snopek, MD
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副調査官:
- Radovan Hurčík, MD
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
サンプリング方法
調査対象母集団
説明
Inclusion Criteria:
General inclusion criteria:
- AGE > 50 years
- No history of supraventricular arrhythmia
- Sinus rhythm at inclusion
- CHADSVASc score > 2 in men (> 3 in female)
- More than 3 specific criteria for inclusion
- Written informed consent is obtained before any study-related assessment is performed
Specific inclusion criteria:
- Age > 65
- Age > 75
- BMI > 30
- Heart failure with preserved LVEF (according to ESC GL for HF)
- Ischemic stroke
- Left atrial diameter > 45mm
- Chronic obstructive pulmonary disease
- Arterial hypertension
- PR interval > 200ms
- History of MI or (objective evidence of) chronic coronary syndrome
- Peripheral artery disease
- Thyroid disease
Exclusion Criteria:
- History of any supraventricular or ventricular arrhythmia (excluding premature contractions and 1st degree AV block)
- Therapy with anticoagulants at the time of inclusion
- Acute coronary syndrome less than 1 month prior to inclusion
- History of cardiac surgery
- Diabetes mellitus type 2
- Reduced LVEF (<50%)
- Acute or decompensated heart failure at the time of inclusion
- Cardiomyopathy
- Systemic inflammatory disease or acute inflammatory disease
- Active malignancy
- Alcoholism (≥ 8 drinks/week)
- Renal Disease (Dialysis/ transplant/ CrCl < 1ml/s)
- Liver disease (cirrhosis/ transaminase > 3x ULT/ bilirubin > 2x ULT)
- Severe or moderate mitral stenosis
- Pregnancy
研究計画
研究はどのように設計されていますか?
デザインの詳細
コホートと介入
グループ/コホート |
介入・治療 |
---|---|
Study Group
Patients in sinus rhythm without history of AF, with high risk for ischemic stroke and AF.
CHA2DS2-VASc score > 2 (for females > 3) and with more than 3 specific criteria for inclusion.
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Sampling of peripheral venous blood for analysis of plasma concentration of plasmatic markers (Apelin, microRNA, FGF-23, IGF-1, IGFBP-1) and routine analysis (laboratory parameters: NT-proBNP, D-dimer, Creatinine Clearance, CRP, Hs-troponin).
ECHO parameters:
Patient receives an ECG Holter for a 7-day monitoring.
A screening test for evaluating cognitive performance of patients done in the clinician's office.
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この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
---|---|---|
Prevalence of AF
時間枠:Within 14 days from Inclusion.
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AF duration > 30s on surface ECG
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Within 14 days from Inclusion.
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Incidence of AF
時間枠:Within 14 days from Inclusion.
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AF duration > 30s on surface ECG
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Within 14 days from Inclusion.
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
---|---|---|
Cardiovascular (CV) death
時間枠:Day 175-205 from inclusion (Follow-up 3) - Day 1080-1110 from inclusion (Follow-up 6)
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Event occurred or did not occur (Yes/No).
|
Day 175-205 from inclusion (Follow-up 3) - Day 1080-1110 from inclusion (Follow-up 6)
|
All cause death
時間枠:Day 175-205 from inclusion (Follow-up 3) - Day 1080-1110 from inclusion (Follow-up 6)
|
Event occurred or did not occur (Yes/No).
|
Day 175-205 from inclusion (Follow-up 3) - Day 1080-1110 from inclusion (Follow-up 6)
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CV death + nonfatal stroke + nonfatal myocardial infarction
時間枠:Day 175-205 from inclusion (Follow-up 3) - Day 1080-1110 from inclusion (Follow-up 6)
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Event occurred or did not occur (Yes/No).
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Day 175-205 from inclusion (Follow-up 3) - Day 1080-1110 from inclusion (Follow-up 6)
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Ischemic stroke
時間枠:Day 175-205 from inclusion (Follow-up 3) - Day 1080-1110 from inclusion (Follow-up 6)
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Event occurred or did not occur (Yes/No).
|
Day 175-205 from inclusion (Follow-up 3) - Day 1080-1110 from inclusion (Follow-up 6)
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Cognitive decline assessed by Mini-Mental State Examination
時間枠:Day 350-380 from inclusion (Follow-up 4) - Day 1080-1110 from inclusion (Follow-up 6)
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Impairment observed and recorded or not observed and not recorded (Yes/No).
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Day 350-380 from inclusion (Follow-up 4) - Day 1080-1110 from inclusion (Follow-up 6)
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Heart failure
時間枠:Day 175-205 from inclusion (Follow-up 3) - Day 1080-1110 from inclusion (Follow-up 6)
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Event occurred or did not occur (Yes/No). If Yes, HF classification to be indicated based on LVEF: i. with preserved LVEF (HFpEF) ii. with mid-range LVEF (HFmrEF) iii. with reduced LVEF (HFrEF) |
Day 175-205 from inclusion (Follow-up 3) - Day 1080-1110 from inclusion (Follow-up 6)
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Hospitalization due to CV cause
時間枠:Day 175-205 from inclusion (Follow-up 3) - Day 1080-1110 from inclusion (Follow-up 6)
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Event occurred or did not occur (Yes/No).
|
Day 175-205 from inclusion (Follow-up 3) - Day 1080-1110 from inclusion (Follow-up 6)
|
Acute coronary syndrome
時間枠:Day 175-205 from inclusion (Follow-up 3) - Day 1080-1110 from inclusion (Follow-up 6)
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Event occurred or did not occur (Yes/No). If Yes, type of ACS to be indicated: i. Unstable angina ii. NSTEMI iii. STEMI |
Day 175-205 from inclusion (Follow-up 3) - Day 1080-1110 from inclusion (Follow-up 6)
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協力者と研究者
スポンサー
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (予想される)
研究の完了 (予想される)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
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