A CALIBER Study: Risk Factors for Stroke, Heart Failure, and Myocardial Infarction in Atrial Fibrillation
NCT ID: NCT01944397
Last Updated: 2013-09-17
Study Results
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Basic Information
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UNKNOWN
125000 participants
OBSERVATIONAL
2011-12-31
2014-12-31
Brief Summary
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Detailed Description
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Conen et al. demonstrated that mortality risk in AF patients is partly mediated by the development of non-fatal stroke, HF, and MI. However, they did not investigate differences in the cumulative incidence of these conditions between different patient groups (e.g. men and women), or the relationship between potential prognostic factors and the development of these conditions. Sets of prognostic factors for stroke and HF in AF patients have been defined through the development of prognostic models, but these models were developed specifically for each condition so it is unclear whether these prognostic factors are associated with increased risk of a particular condition, or simply any major adverse cardiovascular event. Additionally, some potentially important prognostic factors were not evaluated in these studies (e.g. anaemia and kidney failure).
Thus we chose to conduct an exploratory study of prognostic factors for HF, MI, and stroke in patients diagnosed with AF. We selected our candidate factors from those that have previously been associated with stroke, HF, or MI (in AF patients or the general population). Identification of prognostic factors for stroke, HF, and MI in those diagnosed with AF is a first step toward understanding both the development of these conditions, and the scope for targeting preventive treatments to improve prognosis.
This study will be undertaken using linked electronic health record data for primary and secondary care from CALIBER. This data set contains a broad range of clinically relevant, clinically conducted measurements of potential prognostic factors, and also provides a very large baseline sample from which we can draw a sufficient number of incident AF cases to investigate our three endpoints.
The study has two aims. First, to determine the cumulative incidence of fatal and non-fatal heart failure (HF), myocardial infarction (MI) and stroke (ischaemic, haemorrhagic, and NOS) in patients diagnosed with atrial fibrillation (AF). Differences between clinically relevant groups (e.g. men and women) will be explored. Second, to compare the direction and magnitude of associations between prognostic factors and the development of these conditions (HF, stroke, MI) in patients with AF. The following panels of prognostic factors will be investigated: sociodemographic; anthropomorphic and haemodynamic; behavioural; co-existing conditions (cardiovascular and non-cardiovascular); blood biomarkers; secondary preventive drugs.
This study is part of the CALIBER (Cardiovascular disease research using linked bespoke studies and electronic records) programme funded over 5 years from the NIHR and Wellcome Trust. The central theme of the CALIBER research is linkage of the Myocardial Ischaemia National Audit Project (MINAP) with primary care (GPRD) and other resources. The overarching aim of CALIBER is to better understand the aetiology and prognosis of specific coronary phenotypes across a range of causal domains, particularly where electronic records provide a contribution beyond traditional studies. CALIBER has received both Ethics approval (ref 09/H0810/16) and ECC approval (ref ECC 2-06(b)/2009 CALIBER dataset).
Conditions
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Keywords
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Study Design
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COHORT
RETROSPECTIVE
Study Groups
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Atrial fibrillation
Patients with a diagnosis of atrial fibrillation recorded in primary or secondary care during the study period.
No interventions assigned to this group
Eligibility Criteria
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Inclusion Criteria
* Patients in GPRD practices which are deemed "up to standard" by GPRD criteria
* Patients whose records are deemed "acceptable" by GPRD criteria and contain at least one year of data
* Patients whose age and sex, as recorded in GPRD is the same as that recorded in HES.
Exclusion Criteria
30 Years
ALL
Yes
Sponsors
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London School of Hygiene and Tropical Medicine
OTHER
St Bartholomews and The Royal London Hospital
UNKNOWN
University College, London
OTHER
Responsible Party
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Principal Investigators
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Harry Hemingway, FRCP
Role: STUDY_DIRECTOR
University College, London
Katherine I Morley, PhD
Role: PRINCIPAL_INVESTIGATOR
University College, London
Locations
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University College London
London, , United Kingdom
Countries
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Related Links
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CALIBER Data Portal (including additional study information)
Other Identifiers
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086091/Z/08/Z
Identifier Type: OTHER_GRANT
Identifier Source: secondary_id
RP-PG-0407-10314
Identifier Type: OTHER_GRANT
Identifier Source: secondary_id
G0902393
Identifier Type: OTHER_GRANT
Identifier Source: secondary_id
CALIBER-12-03-PROG-18
Identifier Type: -
Identifier Source: org_study_id