The Italian START-Register on anticoagulation with focus on atrial fibrillation

Antonucci, Emilia;Poli, Daniela;Tosetto, Alberto;Pengo, Vittorio;Tripodi, Armando;Magrini, Nicola;Marongiu, Francesco;Palareti Gualtiero;Testa S;Paoletti O;Pengo V;Falanga A;Lerede T;Guazzaloca G;Coagulazione M;Poli D;Marcucci R;Piana A;Cibecchini F;Ruocco L;Lucarelli G;Paparo C;MARTINI, GIUSEPPE;Scovoli G;Bradamante S;Malcangi G;Lombardi M;Insana A;Toma A;Barbera P;Masciocco L;Saracino P;Benvenuto A;Vasselli C;Sangiorgio R;Crippa L;Pedrini S;Bertola F;Rupoli S;Lione D;Pasca S;Roldan V;Rossi V;Bucherini E;Gresele P;Mangione C;Cicconi S;Casasco P;Castaman G;Tosetto A;Liberato NL;Bendotti C;Oriana V;Manotti P;Zighetti ML;Pedico P;Fidone E;Lombardo C;Del Vallo M;Paci OO;Pezzella S;Pezzo M;Ciampa A;Molini G;Ciardiello A;Marietta M;Turrini A;Barcellona D

Member of the Collaboration Group

;Palareti G;Magrini N;Marongiu F;Pengo V;Poli D;Tripodi A.

2015-01-01

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Abstract

START-Register - Survey on anTicoagulated pAtients RegisTer - is an independent, inception-cohort, observational, collaborative database aimed at recording prospectively the clinical history of adult patients starting anticoagulant treatment for any reason and using whatever drug. In this article we present the START-Register and give cross section baseline data focusing on non valvular atrial fibrillation (NVAF). Participants are asked to insert prospectively consecutive patients recorded as electronic file on the web-site of the registry. Required data are: demographic and clinical characteristics of patients, associated risk factors for stroke and bleeding, laboratory routine data, clinical indication for treatment, expected therapeutic range (in cases of treatment with vitamin K antagonists -VKAs). The follow-up is carried out to record: quality of treatment (for patients on VKAs), bleeding complications, thrombotic events, and the onset of any type of associated disease. To date 5252 patients have been enrolled; 97.6% were on VKAs because direct oral anticoagulants (DOAC) have been available in Italy only recently. The median age was 74 years [interquartile range (IQR) 64-80]; males 53.7%. This analysis is focused on the 3209 (61.1%) NVAF patients. Mean CHADS 2 score was 2.1±1.1, CHADSVASc score was 3.1±1.3;median age was 76 years (IQR 70-81); 168 patients (5.3%) had severe renal failure [Creatinine clearance (CrCl) <30 ml/min]. Moderate renal failure (CrCl 30-59 ml/min) was found in 1265 patients (39.5%). The analysis of the START-Register data shows that two-third of patients who started chronic anticoagulant treatment had NVAF, one-third of them was > 80 years with high prevalence of renal failure.