Evaluating the effectiveness and risks of oral anticoagulant treatments in multimorbid frail older subjects with atrial fibrillation using the multidimensional prognostic index: the EURopean study of older subjects with atrial fibrillation—EUROSAF

Mario Barbagallo, Francesco Mattace-Raso, Anna Kearney-Schwartz, Nicola Ferrara, Nicola Veronese, Regina Roller-Wirnsberger, Tuomo Nieminen, Elisabetta Canepa, Laura Pikkarainen, Nicolas Berg, Heidi Gruner, Pedro Marques Da Silva, Gil Gregorio Pedro, Timo Strandberg, Stefania Maggi, Tuomo Nieminen, Heidi Gruner, Philipp Bahrmann, Krzyszof Rewiuk, Juhani RossinenPeter Olexa, Alfonso Cruz-Jentoft, Alessandra Argusti, Mario Durando, Eva Topinkova, Hana Matejovska-Kubesova, Maria Cristina Polidori, Giovanni Ruotolo, Mario Bò, Mario Barbagallo, Nicolò Marchionni, Alberto Pilotto, Hans Jurgen Heppner

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

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.
Original languageEnglish
Pages (from-to)149-154
Number of pages6
JournalEuropean Geriatric Medicine
Volume9
Publication statusPublished - 2018

All Science Journal Classification (ASJC) codes

  • Gerontology
  • Geriatrics and Gerontology

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    Barbagallo, M., Mattace-Raso, F., Kearney-Schwartz, A., Ferrara, N., Veronese, N., Roller-Wirnsberger, R., Nieminen, T., Canepa, E., Pikkarainen, L., Berg, N., Gruner, H., Da Silva, P. M., Pedro, G. G., Strandberg, T., Maggi, S., Nieminen, T., Gruner, H., Bahrmann, P., Rewiuk, K., ... Heppner, H. J. (2018). Evaluating the effectiveness and risks of oral anticoagulant treatments in multimorbid frail older subjects with atrial fibrillation using the multidimensional prognostic index: the EURopean study of older subjects with atrial fibrillation—EUROSAF. European Geriatric Medicine, 9, 149-154.