{
  "abstract": "Background Biochemical markers of inflammation, coagulation and myocardial stress have been associated with both prevalent and incident atrial fibrillation (AF), but little is known about the relationship between biomarker expression and AF burden.Aims Our aim was to investigate the association between cardiovascular biomarkers and AF burden and AF episode duration ≥24 hours.Methods and results In this multicentre observational cohort study, we included 404 patients with paroxysmal AF from the Reappraisal of Atrial Fibrillation: Interaction between Hypercoagulability, Electrical Remodelling and Vascular Destabilisation in the Progression of AF study and evaluated a total of 92 potential cardiovascular blood biomarkers. All patients completed 1 year of follow-up with continuous rhythm monitoring using an implanted loop recorder or a dual-chamber pacemaker. The relationship between biomarker expression and AF was investigated using multiple regression including nine preselected covariates: age, sex, prior heart failure, hypertension, renal insufficiency, prior stroke, coronary artery disease, body mass index and treatment with antiarrhythmic drugs. Elevated levels of N-terminal pro-B-type natriuretic peptide (NT-proBNP) were associated with higher AF burden (incidence rate ratio 1.75, 95% CI 1.75 to 2.06) and AF episode duration ≥24 hours (OR 1.78, 95% CI 1.39 to 2.27). Increased levels of matrix metalloproteinase 2, neurogenic locus notch homologue protein 3 and tumour necrosis factor receptor 2 were additionally associated with AF episode durations ≥24 hours.Conclusions Higher circulating levels of NT-proBNP are associated with increased AF burden and AF episode duration ≥24 hours in patients with paroxysmal AF.Trial registration number NCT02726698.",
  "authors": [
    {
      "affiliations": [
        "Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark",
        "Department of Cardiology, Hospitalsenhed Midt, Viborg, Denmark",
        "Department of Clinical Medicine, Aarhus University, Aarhus, Denmark"
      ],
      "name": "Maria Hee Jung Park Frausing"
    },
    {
      "affiliations": [
        "Department of Cardiology, University Medical Center Groningen, Groningen, The Netherlands"
      ],
      "name": "Michiel Rienstra"
    },
    {
      "affiliations": [
        "Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark",
        "Department of Clinical Medicine, Aarhus University, Aarhus, Denmark"
      ],
      "name": "Mads Brix Kronborg"
    },
    {
      "affiliations": [
        "Cardiovascular Diagnostics, Medtronic Bakken Research Center BV, Maastricht, The Netherlands"
      ],
      "name": "Mirko De Melis"
    },
    {
      "affiliations": [
        "Department of Cardiology, Maastricht University Medical Center, Maastricht, The Netherlands",
        "Department of Physiology, University of Maastricht, Maastricht, The Netherlands"
      ],
      "name": "Ulrich Schotten"
    },
    {
      "affiliations": [
        "Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark",
        "Department of Clinical Medicine, Aarhus University, Aarhus, Denmark"
      ],
      "name": "Jens C Nielsen"
    },
    {
      "affiliations": [
        "Department of Cardiology, Martini Hospital, Groningen, The Netherlands"
      ],
      "name": "Robert Tieleman"
    },
    {
      "affiliations": [
        "Department of Cardiology, Maastricht University Medical Center, Maastricht, The Netherlands",
        "Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands"
      ],
      "name": "Harry JGM Crijns"
    },
    {
      "affiliations": [
        "Department of Cardiology, University Medical Center Groningen, Groningen, The Netherlands"
      ],
      "name": "Isabelle C Van Gelder"
    },
    {
      "affiliations": [
        "Department of Cardiology, University Medical Center Groningen, Groningen, The Netherlands",
        "Dalhousie University, Halifax, Nova Scotia, Canada"
      ],
      "name": "Michelle Samuel"
    }
  ],
  "title": "Association between circulating biomarkers and atrial fibrillation burden in patients with paroxysmal atrial fibrillation: a subanalysis of the RACE V study",
  "uid": "26d0e84f-4fad-57bf-bc95-9b314c744234"
}