GISSI-AF - Use of Valsartan an Angiotensin II AT1-Receptor Blocker in the Prevention of Atrial Fibrillation Recurrence
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ClinicalTrials.gov Identifier: NCT00376272 |
Recruitment Status :
Completed
First Posted : September 14, 2006
Last Update Posted : April 20, 2009
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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
Condition or disease | Intervention/treatment | Phase |
---|---|---|
Atrial Fibrillation | Drug: Valsartan Drug: Placebo | Phase 3 |
Study Type : | Interventional (Clinical Trial) |
Actual Enrollment : | 1442 participants |
Allocation: | Randomized |
Intervention Model: | Parallel Assignment |
Masking: | Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor) |
Primary Purpose: | Treatment |
Official Title: | Randomized, Prospective, Parallel Group, Placebo-Controlled, Multi-Center Study on the Use of Valsartan an Angiotensin II AT1-Receptor Blocker in the Prevention of Atrial Fibrillation Recurrence |
Study Start Date : | November 2004 |
Actual Primary Completion Date : | January 2008 |
Actual Study Completion Date : | March 2008 |

Arm | Intervention/treatment |
---|---|
Experimental: 1 |
Drug: Valsartan |
Placebo Comparator: 2 |
Drug: Placebo |
- To demonstrate that, in patients with history of recent AF treated with the best recommended therapies, the addition of valsartan (titrated up to 320 mg daily) is superior to placebo in reducing over the whole follow-up: [ Time Frame: Time to first AF recurrence ]
- First recurrence of AF, [ Time Frame: time to first AF recurrence ]
- Rate of patients with more than one AF episode, [ Time Frame: end of follow-up ]
- Number of AF episodes [ Time Frame: end of fw-up ]
- Number of hospitalizations for CV reasons [ Time Frame: end of fw-up ]
- Number of all-cause hospitalizations [ Time Frame: end of fw-up ]
- Incidence of thromboembolic events [ Time Frame: end of fw-up ]
- Number of patients who die or with non-fatal thromboembolic events [ Time Frame: end of fw-up ]
- Number of patients in sinus rhythm at the time of each study visit [ Time Frame: end of fw-up ]
- Number of patients in sinus rhythm who did not have any prior AF recurrence during the study [ Time Frame: end of fw-up ]
- Duration and characteristics (ventricular rate) of the first recurrence of AF. [ Time Frame: end of fw-up ]

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Ages Eligible for Study: | 40 Years and older (Adult, Older Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Male or female patients >=40 years of age
- Sinus rhythm
- 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
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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)
- Written informed consent to participate in the study prior to any study procedures
Exclusion Criteria:
- Need for a continuous treatment with ARBs for any clinical reasons
- Contraindications or known hypersensitivity to ARBs
- Persistent standing systolic blood pressure < 110 mmHg
- Recent (<6 weeks) acute myocardial infarction or bypass surgery, or percutaneous coronary intervention
- Clinically significant valvular etiologies
- Thyroid dysfunction
- Indication for pacemaker or ICD implant or for an ablative treatment, recent (<6 months) PM or ICD implant, previous ablative treatment
- Planned cardiac surgery, expected to be performed within 3 months
- Serum creatinine level above 2.5 mg/dL
- Significant liver disease
- Pregnant or lactating women or women of childbearing potential who are not protected from pregnancy by an accepted method of contraception
- 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
- Presence of any non-cardiac disease (e.g. cancer) that is likely to significantly shorten life expectancy
- Treatment with any investigational agent within 1 month before randomization
- Currently decompensated heart failure

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00376272

Study Chair: | Marcello Disertori, MD | Gruppo di Ricerca GISSI | |
Study Chair: | Roberto Latini, MD | Gruppo di Ricerca GISSI |
Publications:
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: | Aldo P. Maggioni, Heart Care Foundation |
ClinicalTrials.gov Identifier: | NCT00376272 |
Other Study ID Numbers: |
G106 |
First Posted: | September 14, 2006 Key Record Dates |
Last Update Posted: | April 20, 2009 |
Last Verified: | April 2009 |
atrial fibrillation,atrial remodeling,dysrhythmias,valsartan |
Atrial Fibrillation Recurrence Arrhythmias, Cardiac Heart Diseases Cardiovascular Diseases Pathologic Processes |
Disease Attributes Valsartan Antihypertensive Agents Angiotensin II Type 1 Receptor Blockers Angiotensin Receptor Antagonists Molecular Mechanisms of Pharmacological Action |