Nozica, Nikolas; Lam, Anna; Goulouti, Eleni; Elchinova, Elena Georgieva; Spirito, Alessandro; Branca, Mattia; Servatius, Helge; Noti, Fabian; Seiler, Jens; Baldinger, Samuel H.; Haeberlin, Andreas; De Marchi, Stefano F.; Asatryan, Babken; Rodondi, Nicolas; Donzé, Jacques; Aujesky, Drahomir; Tanner, Hildegard; Reichlin, Tobias; Jüni, Peter and Roten, Laurent (2021). The SilenT AtRial FIBrillation (STAR-FIB) study programme - design and rationale. Swiss medical weekly, 151, w20421. EMH Schweizerischer Ärzteverlag 10.4414/smw.2021.20421
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AIMS OF THE STUDY
Anticoagulation of patients with screen-detected atrial fibrillation may prevent ischaemic strokes. The STAR-FIB study programme aims to determine the age- and sex-specific prevalence of silent atrial fibrillation and to develop a clinical prediction model to identify patients at risk of undiagnosed atrial fibrillation in a hospitalised patient population.
METHODS
The STAR-FIB study programme includes a prospective cohort study and a case-control study of hospitalised patients aged 65–84 years, evenly distributed for both age and sex. We recruited 795 patients without atrial fibrillation for the cohort study (49.2% females; median age 74.8 years). All patients had three serial 7-day Holter ECGs to screen for silent atrial fibrillation. The primary endpoint will be any episode of atrial fibrillation or atrial flutter of ≥30 seconds duration. The age- and sex-specific prevalence of newly diagnosed atrial fibrillation will be estimated. For the case-control study, 120 patients with paroxysmal atrial fibrillation were recruited as cases (41.7% females; median age 74.6 years); controls will be randomly selected from the cohort study in a 2:1 ratio. All participants in the cohort study and all cases were prospectively evaluated including clinical, laboratory, echocardiographic and electrical parameters. A clinical prediction model for undiagnosed atrial fibrillation will be derived in the case-control study and externally validated in the cohort study.
CONCLUSIONS
The STAR-FIB study programme will estimate the age- and sex-specific prevalence of silent atrial fibrillation in a hospitalised patient population, and develop and validate a clinical prediction model to identify patients at risk of silent atrial fibrillation.
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