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:10.4414/smw.2021.20421

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

Affiliations

Nikolas Nozica: Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Switzerland
Anna Lam: Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Switzerland
Eleni Goulouti: Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Switzerland
Elena Elchinova: Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Switzerland
Alessandro Spirito: Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Switzerland
Mattia Branca: Clinical Trials Unit, University of Bern, Switzerland
Helge Servatius: Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Switzerland
Fabian Noti: Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Switzerland
Jens Seiler: Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Switzerland
Samuel H. Baldinger: Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Switzerland
Andreas Haeberlin: Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Switzerland; Sitem Center for Translational Medicine and Biomedical Entrepreneurship, University of Bern, Switzerland
Stefano F. de Marchi: Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Switzerland
Babken Asatryan: Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Switzerland
Nicolas Rodondi: Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Switzerland; Institute of Primary Health Care (BIHAM), University of Bern, Switzerland
Jacques Donzé: Department of Medicine, Neuchâtel Hospital Network, Neuchâtel, Switzerland; Department of internal medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
Drahomir Aujesky: Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Switzerland
Hildegard Tanner: Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Switzerland
Tobias Reichlin: Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Switzerland
Peter Jüni: Applied Health Research Centre (AHRC), Li Ka Shing Knowledge Institute of St. Michael’s Hospital, Department of Medicine and Institute of Health Policy, Management and Evaluation, University of Toronto, Canada
Laurent Roten: Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Switzerland

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.

Published in Swiss Medical Weekly

ISSN: 1424-7860 (Print); 1424-3997 (Online)
Publisher: SMW supporting association (Trägerverein Swiss Medical Weekly SMW)
Country of publisher: Switzerland
LCC subjects: Medicine
Website: http://www.smw.ch

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