Authors: Joachim R Ehrlich Magdalena Kaluzny Stefan Baumann Ralf Lehmann Stefan H Hohnloser
Publish Date: 2011/07/03
Volume: 100, Issue: 11, Pages: 1029-1036
Abstract
Atrial fibrillation AF is associated not only with inflammation but also with structural remodelling and altered endothelial activation which may contribute to clot formation embolization and mortality We aimed to determine the predictive value of singletime biomarker analysis for prediction of outcome in patients with AFWe conducted a prospective study to evaluate if biomarkers of structural electrical or endothelial remodelling are predictive of cardiovascular events composite primary endpoint of myocardial infarction stroke peripheral embolism or death Secondary endpoint was allcause mortality Patients with any type of AF and without active inflammatory conditions were eligible Plasma samples were collected for ELISA analysis of biomarkers inflammation hsCRP sCD40L structural MMP2 and endothelial remodelling vWF sVCAM1 at enrolment Patients n = 278 were followed for 28 ± 12 median 32 months Eightyeight individuals 32 experienced a primary outcome event including 8 29 with myocardial infarction 13 48 with stroke and 4 15 with peripheral embolism Predictors of the primary endpoint were age 75 years CHADS2score 2 LVEF 35 diabetes presence of an ICD/pacemaker elevated vWF sVCAM1 and MMP2 levels On multivariate regression analysis only age 75 years sVCAM1 and MMP2 levels remained independently associated with the endpoint There were 75 deaths during followup Age 75 years reduced LVEF elevated sVCAM1 and MMP2 levels were predictors of allcause mortality
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