Articles producció científica> Medicina i Cirurgia

Evidence Gaps and Lessons in the Early Detection of Atrial Fibrillation: A Prospective Study in a Primary Care Setting (PREFATE Study).

  • Dades identificatives

    Identificador: imarina:9435582
    Autors:
    Clua-Espuny JLHernández-Pinilla AGentille-Lorente DMuria-Subirats EForcadell-Arenas Tde Diego-Cabanes CRibas-Seguí DDiaz-Vilarasau AMolins-Rojas CPalleja-Millan MSatué-Gracia EMMartín-Luján F
    Resum:
    Background/Objectives: In Europe, the prevalence of AF is expected to increase 2.5-fold over the next 50 years with a lifetime risk of 1 in 3-5 individuals after the age of 55 years and a 34% rise in AF-related strokes. The PREFATE project investigates evidence gaps in the early detection of atrial fibrillation in high-risk populations within primary care. This study aims to estimate the prevalence of device-detected atrial fibrillation (DDAF) and assess the feasibility and impact of systematic screening in routine primary care. Methods: The prospective cohort study (NCT05772806) included 149 patients aged 65-85 years, identified as high-risk for AF. Participants underwent 14 days of cardiac rhythm monitoring using the Fibricheck® app (CE certificate number BE16/819942412), alongside evaluations with standard ECG and transthoracic echocardiography. The primary endpoint was a new AF diagnosis confirmed by ECG or Holter monitoring. Statistical analyses examined relationships between AF and clinical, echocardiographic, and biomarker variables. Results: A total of 18 cases (12.08%) were identified as positive for possible DDAF using FibriCheck® and 13 new cases of AF were diagnosed during follow-up, with a 71.4-fold higher probability of confirming AF in FibriCheck®-positive individuals than in FibriCheck®-negative individuals, resulting in a post-test odds of 87.7%. Significant echocardiographic markers of AF included reduced left atrial strain (<26%) and left atrial ejection fraction (<50%). MVP ECG risk scores ≥ 4 strongly predicted new AF diagnoses. However, inconsistencies in monitoring outcomes and limitations in current guidelines, particularly regarding AF burden, were observed. Conclusions: The study underscores the feasibility and utility of AF screening in primar
  • Altres:

    Autor segons l'article: Clua-Espuny JL; Hernández-Pinilla A; Gentille-Lorente D; Muria-Subirats E; Forcadell-Arenas T; de Diego-Cabanes C; Ribas-Seguí D; Diaz-Vilarasau A; Molins-Rojas C; Palleja-Millan M; Satué-Gracia EM; Martín-Luján F;
    Departament: Medicina i Cirurgia
    Autor/s de la URV: Martín Lujan, Francisco Manuel
    Paraules clau: Ischemic stroke Heart rate determination Electrocardiography Echocardiography/statistics and numerical data Diagnostic techniques and procedures Device detected atrial fibrillation Clinical risk scores Cardiac/diagnosis Atrial fibrillation Arrhythmias Ambulatory/standards
    Resum: Background/Objectives: In Europe, the prevalence of AF is expected to increase 2.5-fold over the next 50 years with a lifetime risk of 1 in 3-5 individuals after the age of 55 years and a 34% rise in AF-related strokes. The PREFATE project investigates evidence gaps in the early detection of atrial fibrillation in high-risk populations within primary care. This study aims to estimate the prevalence of device-detected atrial fibrillation (DDAF) and assess the feasibility and impact of systematic screening in routine primary care. Methods: The prospective cohort study (NCT05772806) included 149 patients aged 65-85 years, identified as high-risk for AF. Participants underwent 14 days of cardiac rhythm monitoring using the Fibricheck® app (CE certificate number BE16/819942412), alongside evaluations with standard ECG and transthoracic echocardiography. The primary endpoint was a new AF diagnosis confirmed by ECG or Holter monitoring. Statistical analyses examined relationships between AF and clinical, echocardiographic, and biomarker variables. Results: A total of 18 cases (12.08%) were identified as positive for possible DDAF using FibriCheck® and 13 new cases of AF were diagnosed during follow-up, with a 71.4-fold higher probability of confirming AF in FibriCheck®-positive individuals than in FibriCheck®-negative individuals, resulting in a post-test odds of 87.7%. Significant echocardiographic markers of AF included reduced left atrial strain (<26%) and left atrial ejection fraction (<50%). MVP ECG risk scores ≥ 4 strongly predicted new AF diagnoses. However, inconsistencies in monitoring outcomes and limitations in current guidelines, particularly regarding AF burden, were observed. Conclusions: The study underscores the feasibility and utility of AF screening in primary care but identifies critical gaps in diagnostic criteria, anticoagulation thresholds, and guideline recommendations.
    Àrees temàtiques: Pharmacology & pharmacy Medicine, research & experimental Medicine (miscellaneous) General biochemistry,genetics and molecular biology Ciencias sociales Biochemistry, genetics and molecular biology (miscellaneous) Biochemistry, genetics and molecular biology (all) Biochemistry & molecular biology
    Accès a la llicència d'ús: https://creativecommons.org/licenses/by/3.0/es/
    Adreça de correu electrònic de l'autor: paco.martin@urv.cat
    Identificador de l'autor: 0000-0003-0359-3588
    Data d'alta del registre: 2025-02-08
    Versió de l'article dipositat: info:eu-repo/semantics/publishedVersion
    Referència a l'article segons font original: Biomedicines. 13 (1):
    Referència de l'ítem segons les normes APA: Clua-Espuny JL; Hernández-Pinilla A; Gentille-Lorente D; Muria-Subirats E; Forcadell-Arenas T; de Diego-Cabanes C; Ribas-Seguí D; Diaz-Vilarasau A; Mo (2025). Evidence Gaps and Lessons in the Early Detection of Atrial Fibrillation: A Prospective Study in a Primary Care Setting (PREFATE Study).. Biomedicines, 13(1), -. DOI: 10.3390/biomedicines13010119
    URL Document de llicència: https://repositori.urv.cat/ca/proteccio-de-dades/
    Entitat: Universitat Rovira i Virgili
    Any de publicació de la revista: 2025
    Tipus de publicació: Journal Publications
  • Paraules clau:

    Biochemistry & Molecular Biology,Biochemistry, Genetics and Molecular Biology (Miscellaneous),Medicine (Miscellaneous),Medicine, Research & Experimental,Pharmacology & Pharmacy
    Ischemic stroke
    Heart rate determination
    Electrocardiography
    Echocardiography/statistics and numerical data
    Diagnostic techniques and procedures
    Device detected atrial fibrillation
    Clinical risk scores
    Cardiac/diagnosis
    Atrial fibrillation
    Arrhythmias
    Ambulatory/standards
    Pharmacology & pharmacy
    Medicine, research & experimental
    Medicine (miscellaneous)
    General biochemistry,genetics and molecular biology
    Ciencias sociales
    Biochemistry, genetics and molecular biology (miscellaneous)
    Biochemistry, genetics and molecular biology (all)
    Biochemistry & molecular biology
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