Swiss Medical Weekly (Feb 2021)

The SilenT AtRial FIBrillation (STAR-FIB) study programme – design and rationale

  • Nikolas Nozica,
  • Anna Lam,
  • Eleni Goulouti,
  • Elena Elchinova,
  • Alessandro Spirito,
  • Mattia Branca,
  • Helge Servatius,
  • Fabian Noti,
  • Jens Seiler,
  • Samuel H. Baldinger,
  • Andreas Haeberlin,
  • Stefano F. de Marchi,
  • Babken Asatryan,
  • Nicolas Rodondi,
  • Jacques Donzé,
  • Drahomir Aujesky,
  • Hildegard Tanner,
  • Tobias Reichlin,
  • Peter Jüni,
  • Laurent Roten

DOI
https://doi.org/10.4414/smw.2021.20421
Journal volume & issue
Vol. 151, no. 0708

Abstract

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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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