GISSI-AF - Use of Valsartan an Angiotensin II AT1-Receptor Blocker in the Prevention of Atrial Fibrillation Recurrence

NCT ID: NCT00376272

Last Updated: 2009-04-20

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

1442 participants

Study Classification

INTERVENTIONAL

Study Start Date

2004-11-30

Study Completion Date

2008-03-31

Brief Summary

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Study purpose The purpose of the study is to show that the addition of valsartan on top of established therapies can reduce the recurrence of atrial fibrillation in patients with a history of recent atrial fibrillation associated with cardiovascular diseases/comorbidities.

Primary objective To demonstrate that, in patients with history of recent atrial fibrillation treated with the best recommended therapies, the addition of valsartan 320 mg is superior to placebo in reducing atrial fibrillation recurrence.

Study design The GISSI-AF is a prospective, multicenter, randomized, double blind, placebo controlled study. Patients with a history of atrial fibrillation will be centrally randomized in a 1:1 ratio to receive either valsartan or placebo.

GISSI-AF will be a pragmatic trial, with broad selection criteria to mimic real clinical practice as much as possible. Since no special examinations or procedures are required for the trial, the economic impact on the National Health Service will be minimized and use of resources likely to be optimized. The enrollment period will last 12 months. The patients will be followed up for 12 months from study entry

All prescribed treatments for AF or for the underlying cardiovascular diseases, including ACE-inhibitors, amiodarone and betablockers, will be allowed:

* patients should be on a stable treatment for at least one month
* the current guideline for hypertension treatment should be applied
* patients should not be started on ARBs during the study

Detailed Description

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The protocol is sponsored by an independent organization and partially supported by Novartis

Conditions

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Atrial Fibrillation

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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1

Group Type EXPERIMENTAL

Valsartan

Intervention Type DRUG

2

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type DRUG

Interventions

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Valsartan

Intervention Type DRUG

Placebo

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

1. Male or female patients \>=40 years of age
2. Sinus rhythm
3. At least two ECG documented episodes of symptomatic AF in the previous 6 months or After a successful cardioversion for AF performed between 14 days and 48 hours before randomization
4. At least one of the following underlying cardiovascular diseases/comorbidities:

* heart failure/documented history of LV dysfunction (defined as an EF \<40%)
* history of hypertension \>=6 months with/without LVH
* Type II diabetes mellitus
* documented history of stroke or peripheral vascular disease
* documented history of coronary artery disease
* lone atrial fibrillation with documented LA dilation (LA diameter \>=45 mm for men and \>=40 mm for women)
5. Written informed consent to participate in the study prior to any study procedures

Exclusion Criteria

1. Need for a continuous treatment with ARBs for any clinical reasons
2. Contraindications or known hypersensitivity to ARBs
3. Persistent standing systolic blood pressure \< 110 mmHg
4. Recent (\<6 weeks) acute myocardial infarction or bypass surgery, or percutaneous coronary intervention
5. Clinically significant valvular etiologies
6. Thyroid dysfunction
7. Indication for pacemaker or ICD implant or for an ablative treatment, recent (\<6 months) PM or ICD implant, previous ablative treatment
8. Planned cardiac surgery, expected to be performed within 3 months
9. Serum creatinine level above 2.5 mg/dL
10. Significant liver disease
11. Pregnant or lactating women or women of childbearing potential who are not protected from pregnancy by an accepted method of contraception
12. Any condition that in the opinion of the investigator would jeopardize the evaluation of efficacy or safety or be associated with poor adherence to the protocol
13. Presence of any non-cardiac disease (e.g. cancer) that is likely to significantly shorten life expectancy
14. Treatment with any investigational agent within 1 month before randomization
15. Currently decompensated heart failure
Minimum Eligible Age

40 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Gruppo di Ricerca GISSI

OTHER

Sponsor Role lead

Responsible Party

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Heart Care Foundation

Principal Investigators

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Marcello Disertori, MD

Role: STUDY_CHAIR

Gruppo di Ricerca GISSI

Roberto Latini, MD

Role: STUDY_CHAIR

Gruppo di Ricerca GISSI

Locations

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Ospedale Valdichiana Santa Margherita

Cortona, AR, Italy

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Ospedale Cardinal Massaia

Asti, AT, Italy

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Azienda Ospedaliera Giuseppe Moscati

Avellino, AV, Italy

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Ospedale Consorziale Policlinico

Bari, BA, Italy

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Ospedale di Venere

Bari - Carbonara, BA, Italy

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Ospedali Riuniti di Bergamo

Bergamo, BG, Italy

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Ospedale di Bentivoglio

Bentivoglio, BO, Italy

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Ospedale Maggiore

Bologna, BO, Italy

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Ospedale Bellaria

Bologna, BO, Italy

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Casa di Cura Poliambulanza

Brescia, BS, Italy

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Ospedale Civile Mellini

Chiari, BS, Italy

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Ospedlae Generale Regionale

Bolzano, BZ, Italy

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Azienda Ospedaliera G. Brotzu - S. Michele

Cagliari, CA, Italy

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Presidio Ospedaliero Moscati

Aversa, CE, Italy

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Azienda Ospedaliera Sant'Anna e San Sebastiano

Caserta, CE, Italy

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Ospedale Civile Ave Gratia Plena

Piedimonte Matese, CE, Italy

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Ospedale Ave Gratia Plena

San Felice A Cancello, CE, Italy

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Ospedale San Giuseppe e Melorio

Santa Maria Capua Vetere, CE, Italy

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Azienda Ospedaliera Santa Croce e Carle

Cuneo, CN, Italy

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Ospedale Civile Saluzzo

Saluzzo, CN, Italy

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Ospedlae Maggiore

Crema, CR, Italy

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Istituti Ospitalieri di Cremona

Cremona, CR, Italy

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Ospedale Santissima Annunziata

Cosenza, CS, Italy

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Presidio Ospedaliero Mariano Santo

Cosenza, CS, Italy

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Ospedale San Francesco di Paola

Paola, CS, Italy

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Ospedale Santa Barbara

Rogliano, CS, Italy

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Presidio Ospedaliero San Marco Argentano

San Marco Argentano, CS, Italy

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Ospedale Civile "G. Chidichimo"

Trebisacce, CS, Italy

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Ospedale Garibaldi - Nesima

Catania, CT, Italy

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Ospedale Civile Pugliese

Catanzaro, CZ, Italy

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Ospedale Civile

Lamezia Terme, CZ, Italy

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Azienda Ospedaliera Mater Domini

Località Germaneto - Catanzaro, CZ, Italy

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Ospedale G. Basilotta

Nicosia, EN, Italy

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Arcispedale Sant'Anna

Ferrara, FE, Italy

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Ospedale Santa Maria Annunziata

Bagno a Ripoli, FI, Italy

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Nuovo Ospedale San Giovanni di Dio

Florence, FI, Italy

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Ospedali Civili di Sampierdarena

Genova-Sampierdarena, GE, Italy

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Ospedale San Carlo

Genova-Voltri, GE, Italy

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Ospedale Civile San Paolo

Monfalcone, GO, Italy

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Ospedale Civile

Imperia, IM, Italy

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Ospedale Civile San Giovanni di Dio

Crotone, KR, Italy

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Presidio Ospedaliero F. Ferrari

Casarano, LE, Italy

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Ospedale Ignazio Veris Delli Ponti

Scorrano, LE, Italy

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Ospedale Civile Bassa Val di Cecina

Cecina, LI, Italy

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Ospedali Riuniti

Livorno, LI, Italy

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Ospedale del dono Svizzero

Formia, LT, Italy

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Ospedale Civile Campo di Marte

Lucca, LU, Italy

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Ospedale Civile

Milazzo, ME, Italy

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Ospedale Carlo Borella

Giussano, MI, Italy

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Ospedale San Raffaele

Milan, MI, Italy

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Istituto Clinico Humanitas

Rozzano, MI, Italy

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Multimedica SPA

Sesto San Giovanni, MI, Italy

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Ospedale Policlinico

Modena, MO, Italy

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Nuovo Ospedale Civile di Sassuolo

Sassuolo, MO, Italy

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Ospedale Madonna delle Grazie

Matera, MT, Italy

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Ospedale Civile

Policoro, MT, Italy

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Ospedale Buccheri La Ferla Fatebenefratelli

Palermo, PA, Italy

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A.R.N.A.S. Ospedale Civico e Benfratelli

Palermo, PA, Italy

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Ospedale V. Cervello

Palermo, PA, Italy

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Presidio Ospedaliero Villa Sofia

Palermo, PA, Italy

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Ospedale Generale Provinciale

Este, PD, Italy

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Ospedale Civile San Massimo

Penne, PE, Italy

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Ospedale Alta Valle del Tevere

Città di Castello, PG, Italy

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Nuovo Ospedale San Giovanni Battista

Foligno, PG, Italy

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Azienda Ospedaliera S. Maria degli Angeli

Pordenone, PN, Italy

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Ospedale Civile

Fidenza, PR, Italy

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Azienda Ospedaliera San Salvatore

Pesaro, PU, Italy

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IRCCS - Fondazione Salvatore Maugeri

Pavia, PV, Italy

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Ospedale Policlinico San Matteo IRCCS

Pavia, PV, Italy

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Csa di Cura Villa Maria Cecilia

Cotignola, RA, Italy

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Ospedale Santa Maria degli Ungheresi

Polistena, RC, Italy

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Policlinico Madonna della Consolazione

Reggio Calabria, RC, Italy

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Ospedale Scillesi D'America

Scilla, RC, Italy

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Ospedali Riuniti Albano-Genzano

Albano Laziale, RM, Italy

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Ospedale San Filippo Neri

Roma, RM, Italy

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CTO

Roma, RM, Italy

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Ospedale San Giovanni

Roma, RM, Italy

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Ospedale San Camillo

Roma, RM, Italy

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Ospedale San Camillo

Roma, RM, Italy

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Ospedale Sant'Andrea

Roma, RM, Italy

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Ospedale Infermi

Rimini, RN, Italy

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Casa di Cura Madonna della Salute

Porto Viro, RO, Italy

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Presidio Ospedaliero

Rovigo, RO, Italy

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Ospedale G. Fucito

Mercato San Severino, SA, Italy

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Ospedale San Luca

Vallo della Lucania, SA, Italy

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Ospedale San Bartolomeo

Sarzana - Loc. Santa Caterina, SP, Italy

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Ospedale Santa Corona

Pietra Ligure, SV, Italy

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Casa di Cura Villa Verde

Taranto, TA, Italy

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Ospedale SS. Annunziata

Taranto, TA, Italy

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Ospedale Civile G. Mazzini

Teramo, TE, Italy

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Ospedale di Cles

Cles, TN, Italy

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Casa di Cura Villa Bianca

Trento, TN, Italy

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Ospedale Evangelico Valdese

Torino, TO, Italy

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Azienda USL 4 Terni

Terni, TR, Italy

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Ospedale Santa Chiara

Trento, TR, Italy

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Azienda Servizi Sanitari N. 1 Triestina

Trieste, TS, Italy

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Azienda Ospedaliera - Univ. Ospedali Riuniti

Trieste, TS, Italy

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Ospedale De Gironcoli

Conegliano Veneto, TV, Italy

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Ospedale Santa Maria dei Battuti

Conegliano Veneto, TV, Italy

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Ospedale di Ialmicco - Palmanova - Udine

Palmanova, UD, Italy

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Ospedale S. Antonio

San Daniele del Friuli, UD, Italy

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Santa Maria della Misericordia

Udine, UD, Italy

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Azienda Ospedaliera e Universitaria

Varese, VA, Italy

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Ospedale Civile Umberto I

Mestre, VE, Italy

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Ospedale Civile

Mirano, VE, Italy

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Ospedale Civile San Biagio

Bovolone, VR, Italy

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Ospedale G. Fra Castoro

San Bonifacio, VR, Italy

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Presidio Ospedaliero

Soriano Calabro, VV, Italy

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Ospedale Civile G. Jazzolino

Vibo Valentia, VV, Italy

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Ospedale Generale di Zona

Giugliano in Campania, , Italy

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Azienda Ospedaliera Vincenzo Monaldi

Napoli, , Italy

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Policlinico Universitario Federico II

Napoli, , Italy

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Ospedale Santa Maria delle Grazie

Pozzuoli, , Italy

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Cardiocentro Ticino

Lugano, , Switzerland

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Countries

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Italy Switzerland

References

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Disertori M, Latini R, Maggioni AP, Delise P, Di Pasquale G, Franzosi MG, Staszewsky L, Tognoni G; GISSI-AF Investigators. Rationale and design of the GISSI-Atrial Fibrillation Trial: a randomized, prospective, multicentre study on the use of valsartan, an angiotensin II AT1-receptor blocker, in the prevention of atrial fibrillation recurrence. J Cardiovasc Med (Hagerstown). 2006 Jan;7(1):29-38. doi: 10.2459/01.JCM.0000199778.85343.08.

Reference Type BACKGROUND
PMID: 16645357 (View on PubMed)

GISSI-AF Investigators; Disertori M, Latini R, Barlera S, Franzosi MG, Staszewsky L, Maggioni AP, Lucci D, Di Pasquale G, Tognoni G. Valsartan for prevention of recurrent atrial fibrillation. N Engl J Med. 2009 Apr 16;360(16):1606-17. doi: 10.1056/NEJMoa0805710.

Reference Type BACKGROUND
PMID: 19369667 (View on PubMed)

Disertori M, Franzosi MG, Barlera S, Cosmi F, Quintarelli S, Favero C, Cappellini G, Fabbri G, Maggioni AP, Staszewsky L, Moroni LA, Latini R; GISSI-AF investigators. Thromboembolic event rate in paroxysmal and persistent atrial fibrillation: data from the GISSI-AF trial. BMC Cardiovasc Disord. 2013 Apr 15;13:28. doi: 10.1186/1471-2261-13-28.

Reference Type DERIVED
PMID: 23586654 (View on PubMed)

Staszewsky L, Wong M, Masson S, Raimondi E, Gramenzi S, Proietti G, Bicego D, Emanuelli C, Pulitano G, Taddei F, Nicolis EB, Correale E, Fabbri G, Bertocchi F, Franzosi MG, Maggioni AP, Tognoni G, Disertori M, Latini R; GISSI-AF Investigators. Left atrial remodeling and response to valsartan in the prevention of recurrent atrial fibrillation: the GISSI-AF echocardiographic substudy. Circ Cardiovasc Imaging. 2011 Nov;4(6):721-8. doi: 10.1161/CIRCIMAGING.111.965954. Epub 2011 Sep 16.

Reference Type DERIVED
PMID: 21926261 (View on PubMed)

Disertori M, Lombardi F, Barlera S, Maggioni AP, Favero C, Franzosi MG, Lucci D, Staszewsky L, Fabbri G, Quintarelli S, Bianconi L, Latini R. Clinical characteristics of patients with asymptomatic recurrences of atrial fibrillation in the Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico-Atrial Fibrillation (GISSI-AF) trial. Am Heart J. 2011 Aug;162(2):382-9. doi: 10.1016/j.ahj.2011.05.008. Epub 2011 Jul 7.

Reference Type DERIVED
PMID: 21835301 (View on PubMed)

Disertori M, Lombardi F, Barlera S, Latini R, Maggioni AP, Zeni P, Di Pasquale G, Cosmi F, Franzosi MG; GISSI-AF Investigators. Clinical predictors of atrial fibrillation recurrence in the Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico-Atrial Fibrillation (GISSI-AF) trial. Am Heart J. 2010 May;159(5):857-63. doi: 10.1016/j.ahj.2010.02.016.

Reference Type DERIVED
PMID: 20435196 (View on PubMed)

Related Links

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Other Identifiers

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G106

Identifier Type: -

Identifier Source: org_study_id

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