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

Area of Science:

• Cardiology
• Geriatrics
• Public Health

Background:

• Screening for atrial fibrillation (AF) in hospitalized patients can identify individuals at risk for ischemic stroke.
• Silent AF, often asymptomatic, poses a significant stroke risk and necessitates effective detection strategies.
• The STAR-FIB study addresses the need for understanding AF prevalence and developing predictive tools in a specific patient demographic.

Purpose of the Study:

• To determine the age- and sex-specific prevalence of silent atrial fibrillation in hospitalized patients aged 65-84 years.
• To develop and validate a clinical prediction model for identifying patients at risk of undiagnosed atrial fibrillation.
• To inform anticoagulation strategies for stroke prevention in this population.

Main Methods:

• Prospective cohort study involving 795 hospitalized patients (aged 65-84) undergoing three serial 7-day Holter ECGs.
• Case-control study with 120 patients diagnosed with paroxysmal atrial fibrillation, with controls selected from the cohort.
• Derivation and external validation of a clinical prediction model using clinical, laboratory, echocardiographic, and electrical parameters.

Main Results:

• The study will estimate the prevalence of newly diagnosed atrial fibrillation stratified by age and sex.
• A clinical prediction model will be developed to identify individuals with a higher likelihood of undiagnosed atrial fibrillation.
• Data from the cohort and case-control studies will be used for model development and validation.

Conclusions:

• The STAR-FIB study will provide crucial data on the prevalence of silent atrial fibrillation in hospitalized older adults.
• A validated clinical prediction model will aid in targeted screening and early intervention for atrial fibrillation.
• Findings are expected to improve stroke prevention strategies through timely anticoagulation therapy.