Evidence mapPaperPMID 42334441Full record

Trial reportEuropace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology2026

Interactions of blood biomolecules with early rhythm control in atrial fibrillation patients: exploratory analysis of the EAST-AFNET 4 biomolecule study.

Christoph Al-Taie, Julius Obergassel, Katrin Borof, Julius Ridder, Andreas Rillig, Andreas Metzner, Andreas Goette, Christina Magnussen, Moritz F Sinner, Laura C Sommerfeld and 7 more

Registry-linked trialAbstract readRandomized Controlled TrialMulticenter Study
In one paragraph

Trial report in Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01288352 (Early Therapy of Atrial Fibrillation for Stroke Prevention Trial), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01288352 phase4completednot on this map

Early Therapy of Atrial Fibrillation for Stroke Prevention Trial (EAST).

TypeinterventionalSponsorAtrial Fibrillation NetworkRan2011 to 2020Enrolled2,789ConditionsAtrial Fibrillation, StrokeArmsearly standardised rhythm control
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Christoph Al-TaieUniversity Centre of Cardiovascular Science, University Medical Center Hamburg Eppendorf, Martinistr 52, 20246 Hamburg, Germany.ORCID 0000-0001-7088-3943
Julius ObergasselUniversity Centre of Cardiovascular Science, University Medical Center Hamburg Eppendorf, Martinistr 52, 20246 Hamburg, Germany.ORCID 0000-0002-3905-0203
Katrin BorofDepartment of Cardiology, University Heart and Vascular Centre Hamburg (UHZ), Martinistr. 52, 20246 Hamburg, Germany.
Julius RidderUniversity Centre of Cardiovascular Science, University Medical Center Hamburg Eppendorf, Martinistr 52, 20246 Hamburg, Germany.ORCID 0009-0005-7061-8441
Andreas RilligDepartment of Cardiology, University Heart and Vascular Centre Hamburg (UHZ), Martinistr. 52, 20246 Hamburg, Germany.ORCID 0000-0003-3457-0936
Andreas MetznerDepartment of Cardiology, University Heart and Vascular Centre Hamburg (UHZ), Martinistr. 52, 20246 Hamburg, Germany.ORCID 0000-0002-6818-6396
Andreas GoetteDepartment of Cardiology and Intensive Care Medicine, Saint Vincenz Hospital Paderborn, Paderborn, Germany.ORCID 0000-0002-8223-7209
Christina MagnussenDepartment of Cardiology, University Heart and Vascular Centre Hamburg (UHZ), Martinistr. 52, 20246 Hamburg, Germany.ORCID 0000-0002-5102-0955
Moritz F SinnerAtrial Fibrillation NETwork (AFNET), Mendelstr. 11, 48149 Münster, Germany.ORCID 0000-0002-6660-796X
Laura C SommerfeldUniversity Centre of Cardiovascular Science, University Medical Center Hamburg Eppendorf, Martinistr 52, 20246 Hamburg, Germany.ORCID 0000-0001-9837-8770
Stephan WillemsAtrial Fibrillation NETwork (AFNET), Mendelstr. 11, 48149 Münster, Germany.ORCID 0000-0002-8890-5749
Tanja ZellerGerman Centre for Cardiovascular Research (DZHK), Partner Site North, Martinistr. 52, 20246 Hamburg, Germany.ORCID 0000-0003-3379-2641
Renate B SchnabelUniversity Centre of Cardiovascular Science, University Medical Center Hamburg Eppendorf, Martinistr 52, 20246 Hamburg, Germany.ORCID 0000-0001-7170-9509
Ulrich SchottenAtrial Fibrillation NETwork (AFNET), Mendelstr. 11, 48149 Münster, Germany.ORCID 0000-0003-1532-3315
Antonia ZapfGerman Centre for Cardiovascular Research (DZHK), Partner Site North, Martinistr. 52, 20246 Hamburg, Germany.ORCID 0000-0002-8467-0508
Paulus KirchhofDepartment of Cardiology, University Heart and Vascular Centre Hamburg (UHZ), Martinistr. 52, 20246 Hamburg, Germany.ORCID 0000-0002-1881-0197
Larissa FabritzUniversity Centre of Cardiovascular Science, University Medical Center Hamburg Eppendorf, Martinistr 52, 20246 Hamburg, Germany.ORCID 0000-0002-9241-1733

Funding

AbbottAFNET 81Z0710110AFNET 81Z0710116AFNET 81Z0710125British Heart Foundation AA/18/2/34218DZHK 81X2800182DZHK 81Z0710102Early Treatment of Atrial Fibrillation for Stroke Prevention TrialEHRAElse Kröner-Fresenius FoundationEuropean Union Horizon 2020 633196European Union Horizon 2020 847770European Union Innovative Health Initiative Joint 101252780German Heart Foundation 633196German Ministry of Education and ResearchGerman Ministry of Education and Research 01 GI 0204German Research Foundation 509167694Leducq FoundationMAESTRIA 965286SanofiSt. Jude Medical
6 · The paper itself

Abstract

aimsEarly rhythm control reduces cardiovascular events in patients with atrial fibrillation (AF) and cardiovascular comorbidities. Whether this effect is consistent across severities of different AF-associated conditions is not known.

methodsIn the EAST-AFNET 4 biomolecule study (n = 1586; median age 70 years; 45% women), 14 circulating biomarkers reflecting inflammation, fibrosis, ageing, cardiac strain, and myocardial damage were quantified. Log-transformed, winsorized biomarkers were analysed in quintiles to detect non-linear associations and as continuous parameters. Cox proportional hazards models evaluated associations with the primary outcome (cardiovascular death, stroke, or unplanned hospitalization for heart failure or acute coronary syndrome) and the safety outcome (death, stroke, or major bleeding) of the trial, including interaction terms for biomarkers and randomized treatment [early rhythm control (ERC) vs. usual care (UC)]. Two independent cohorts, BBC-AF resembling UC and a TRUST snapshot resembling ERC were combined for external replication. All tests were exploratory.

resultsERC reduced the primary outcome consistently across biomarker concentrations. No signal for treatment interaction was observed for 13 of 14 biomarkers for the primary outcome. For BMP10, a nominal interaction was observed in categorical analyses, suggesting an attenuated treatment effect of ERC in patients in the lowest BMP10 quintile. No interaction was detected for continuous parameters. Similar patterns were observed in exploratory analyses of the replication cohort.

conclusionERC therapy is effective across patients with different severities of conditions associated with AF as quantified by biomolecule concentrations. A potentially attenuated effect of ERC with low BMP10 concentrations warrants further research.This analysis is part of the EAST-AFNET 4 trial biomolecule study, the original trial has been registered under the official title: Early Therapy of Atrial Fibrillation for Stroke Prevention Trial (EAST) (EudraCT 2010-021258-20) at https://clinicaltrials.gov/study/NCT01288352.

Indexed as

Anti-Arrhythmia AgentsAtrial FibrillationHeart RateAcute Coronary SyndromeAgedBiomarkersFemaleHeart FailureHumansMaleMiddle AgedRisk FactorsStrokeTime FactorsTreatment OutcomeAnti-Arrhythmia AgentsBiomarkersAtrial fibrillationBMP10Cardiovascular biomarkersEarly rhythm controlInteraction analysis

Identifiers

PMID42334441
PMCPMC13390925

What Socratic holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.