TY - JOUR
T1 - Evaluating the effectiveness and risks of oral anticoagulant treatments in multimorbid frail older subjects with atrial fibrillation using the multidimensional prognostic index
T2 - the EURopean study of older subjects with atrial fibrillation—EUROSAF
AU - Veronese, Nicola
AU - Argusti, Alessandra
AU - EUROSAF Study Investigators
AU - Canepa, Elisabetta
AU - Polidori, Maria Cristina
AU - Maggi, Stefania
AU - Strandberg, Timo
AU - Pilotto, Alberto
AU - Mattace-Raso, Francesco
N1 - Funding: This is a study of the Comprehensive Geriatric Assessment (CGA)-Special Interest Group of the European Union Geriatric Medicine Society. Funding for this study was provided by an unrestricted contribution by Bayer Pharma AG.
Publisher Copyright: © 2018, European Geriatric Medicine Society.
PY - 2018/4/1
Y1 - 2018/4/1
N2 - Background: Previous studies suggested that a different risk of mortality may influence the oral anticoagulant prescription in older patients with atrial fibrillation (AF). Recently, the Multidimensional Prognostic Index (MPI) demonstrated a high grade of accuracy, calibration and feasibility to predict mortality in hospitalized and community-dwelling older people. Prognostic information, as calculated by the MPI, however, is not included in the decision algorithm of treatments in older patients with AF Purpose: The aim of this international multicenter prospective observational study was to evaluate whether a different prognostic profile, as determined by the MPI, is associated with different treatments for AF (no treatment vs oral anticoagulants) and differences in the main outcomes, i.e., mortality, major thromboembolic events and side effects. Materials and methods: Older hospitalized patients (age ≥ 65 years) with non-valvular AF will be consecutively enrolled in an European, cross-national, prospective, observational study. At baseline, functional and clinical information will be collected to calculate the MPI, CHA2DS2-VASc score, HAS-BLED score, pharmacological treatments (and the compliance during follow-up) and main and secondary diagnoses. During the 12-month follow-up period, information on survival, major thromboembolic events and major bleeding will be collected. For these aims, a sample size of 3000 people was deemed as sufficient. Conclusions: The EUROSAF study has the main objective of evaluating in a population of hospitalized older subjects with AF the clinical benefit/risk ratio of the oral anticoagulant treatments in terms of mortality, major thromboembolic events and bleeding side-effects, giving important information regarding the appropriate prescription of anticoagulant therapy in this population. ClinicalTrials.gov Identifier: NCT02973984.
AB - Background: Previous studies suggested that a different risk of mortality may influence the oral anticoagulant prescription in older patients with atrial fibrillation (AF). Recently, the Multidimensional Prognostic Index (MPI) demonstrated a high grade of accuracy, calibration and feasibility to predict mortality in hospitalized and community-dwelling older people. Prognostic information, as calculated by the MPI, however, is not included in the decision algorithm of treatments in older patients with AF Purpose: The aim of this international multicenter prospective observational study was to evaluate whether a different prognostic profile, as determined by the MPI, is associated with different treatments for AF (no treatment vs oral anticoagulants) and differences in the main outcomes, i.e., mortality, major thromboembolic events and side effects. Materials and methods: Older hospitalized patients (age ≥ 65 years) with non-valvular AF will be consecutively enrolled in an European, cross-national, prospective, observational study. At baseline, functional and clinical information will be collected to calculate the MPI, CHA2DS2-VASc score, HAS-BLED score, pharmacological treatments (and the compliance during follow-up) and main and secondary diagnoses. During the 12-month follow-up period, information on survival, major thromboembolic events and major bleeding will be collected. For these aims, a sample size of 3000 people was deemed as sufficient. Conclusions: The EUROSAF study has the main objective of evaluating in a population of hospitalized older subjects with AF the clinical benefit/risk ratio of the oral anticoagulant treatments in terms of mortality, major thromboembolic events and bleeding side-effects, giving important information regarding the appropriate prescription of anticoagulant therapy in this population. ClinicalTrials.gov Identifier: NCT02973984.
UR - http://www.scopus.com/inward/record.url?scp=85044592351&partnerID=8YFLogxK
U2 - 10.1007/s41999-018-0026-6
DO - 10.1007/s41999-018-0026-6
M3 - Article
C2 - 34654263
AN - SCOPUS:85044592351
SN - 1878-7649
VL - 9
SP - 149
EP - 154
JO - European Geriatric Medicine
JF - European Geriatric Medicine
IS - 2
ER -