TITLE: Atrial Fibrillation Research in Catalonia (AFRICAT): Sequential Clinic-Electro-Biological Screening among high risk individuals.
It is a coordinated project with three subprojects:
- Joan Montaner Villalonga
Institut de Recerca Hospital Universitari Vall d’Hebron
- Ángel Alonso Pedrote Martínez
Hospitales Universitarios Virgen del Rocío – Sevilla
- Josep Lluís Clua Espuny
CAP El Temple – Institut Català de la Salut – Tortosa
Atrial fibrillation (AF) is one the major causes of morbidity and mortality, and it increases death risk, congestive heart failure and the risk for systemic embolism, including stroke. AF diagnosis is a challenge because of its paroxysmal nature, especially at the initial phases of the disease. Improvements in AF detection would have a massive beneficial impact in healthcare systems. However, systematic screening programs have failed to show a clear benefit.
In this project we will create and apply a sequential screening program in a high-risk population by integrating clinical, electrocardiographic and biological information. The study will be therefore divided into 2 different phases of generation and validation of the screening program.
In the first phase, 100 patients will receive a comprehensive assessment to evaluate which variables would be the best in predicting AF. In these patients we will complete clinical assessment, testing of different pulse devices for AF screening, discovery of blood biomarkers for AF by aptamers technology and RNA expression, and validation of biological candidates from the literature and our previous results. AF diagnosis will be based on detection in 4-week Holter-EKG monitoring.
In the second phase, we will apply the best candidates in a sequential screening program in a high-risk population of our health area (aged 75-85 with hypertension and diabetes). The screening will consist of selection of the highest-risk patients by clinical variables and performing of pulse device detection. Biomarkers will be measured in the negative cases to perform Holter-EKG monitoring in the highest-risk patients. In the final step of the study, cost-efficacy analyses will be carried out.
This screening program could be applied at the community level, having a wide social and economical impact in terms of reduction of cardiovascular mortality, disability due to stroke and heart failure, and reduction of the related costs.