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Swiss Atrial Fibrillation Cohort Study

English title Swiss Atrial Fibrillation Cohort Study
Applicant Osswald Stefan
Number 148474
Funding scheme Cohort Studies Large
Research institution Klinik Innere Medizin Universitätsspital Basel
Institution of higher education University of Basel - BS
Main discipline Clinical Cardiovascular Research
Start/End 01.04.2014 - 31.03.2018
Approved amount 5'080'996.00
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All Disciplines (3)

Discipline
Clinical Cardiovascular Research
Cardiovascular Diseases
Internal Medicine

Keywords (10)

Cardiovascular diseases; Stroke; Dementia; Epidemiology; Genetics; Risk prediction; Magnetic resonance imaging; Electrocardiography; Atrial fibrillation; Biomarkers

Lay Summary (German)

Lead
Vorhofflimmern ist die häufigste Herzrhythmusstörung in der Bevölkerung. In den letzten Jahren wurde vermehrt ein Zusammenhang zwischen Vorhofflimmern und verminderter Hirnleistung (Demenz) beschrieben. Dieses Projekt bildet die Grundlage für ein besseres mechanistisches Verständnis für diesen Zusammenhang und dessen gesundheitlichen und ökonomischen Konsequenzen.
Lay summary

Inhalt und Ziele des Forschungsprojekts

Vorhofflimmern ist die häufigste Rhythmusstörung in der Bevölkerung. In der Schweiz haben mehr als 100‘000 Personen diese Erkrankung. Patienten mit Vorhofflimmern haben ein erhöhtes Risiko, an einer Herzschwäche, einem Schlaganfall und/oder einer eingeschränkten Hirnleistung zu erkranken. Um bessere Erkenntnisse über den Zusammenhang zwischen Vorhofflimmern und eingeschränkter Hirnleistung zu gewinnen, führen wir eine langfristige Beobachtungsstudie an mehreren medizinischen Zentren in der Schweiz mit insgesamt 2600 Patienten durch. Wichtigstes Einschlusskriterium für die Studie ist ein dokumentiertes Vorhofflimmern, die meisten Teilnehmer müssen über 65 Jahre alt sein.

Die Studienuntersuchungen werden in jährlichen Abständen durchgeführt und umfassen neben einer Vielzahl von Gesundheitsfragebögen eine Blutentnahme, eine Herzstromkurve (EKG), Fragebögen zur Testung der Hirnfunktion und eine Magnetresonanztomographie des Kopfs (jedes 2. Jahr). Die Dauer des Projekts beträgt mindestens 4 Jahre. Neben den erwähnten Untersuchungen werden auch die wichtigsten klinischen Komplikationen in dieser Patientengruppe wie Schlaganfall oder Herzschwäche systematisch erfasst.

Wissenschaftlicher und gesellschaftlicher Kontext des Forschungsprojekts

Vorhofflimmern und Demenz sind häufige Alterserkrankungen. Beide Entitäten werden aufgrund des zunehmenden Alters der Schweizer Bevölkerung weiter an Häufigkeit zunehmen. Ein besseres Verständnis der Grundlagen der kognitiven Einschränkung bei Patienten mit Vorhofflimmern ist dringend gefordert, um allenfalls neue Therapieansätze zu entwickeln und effizientere Behandlungspfade für diese wachsende Population zu definieren.

Direct link to Lay Summary Last update: 19.03.2014

Responsible applicant and co-applicants

Employees

Project partner

Natural persons


Name Institute

Publications

Publication
Design of the Swiss Atrial Fibrillation Cohort Study (Swiss-AF): structural brain damage and cognitive decline among patients with atrial fibrillation
(2017), Design of the Swiss Atrial Fibrillation Cohort Study (Swiss-AF): structural brain damage and cognitive decline among patients with atrial fibrillation, in Swiss Medical Weekly, 147(2728), w14467.

Collaboration

Group / person Country
Types of collaboration
University Hospital Lausanne, Prof. Peter Vollenweider Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
Helsana, Department of Health Sciences; Dr. Oliver Reich Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
- Research Infrastructure
- Industry/business/other use-inspired collaboration
Universita della Svizzera Italiana, Institute for Computational Science Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
- Research Infrastructure
McMaster University, Hamilton, Ca; Guillaume Paré Canada (North America)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
- Research Infrastructure
Ecole polytechnique federale de Lausanne, Applied signal processing group, Jean-Marc Vesin Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
- Research Infrastructure
Ospedale Regionale di Lugano; Giorgio Moschovitis Switzerland (Europe)
- Publication
- Research Infrastructure
Medical Outpatient Clinic, Lausanne; Carole Clair Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
- Research Infrastructure
Brigham & Women's Hospital, Harvard Medical School, Boston, MA; Prof. Christine Albert MD MPH United States of America (North America)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
Ospedale Regionale di Bellinzona; Marcello di Valentino Switzerland (Europe)
- Publication
- Research Infrastructure
Schiller AG, Roger Abaecherli Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Industry/business/other use-inspired collaboration
Institute for Social and Preventive Medicine Zurich; PD Dr. Matthias Schwenkglenks Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
- Research Infrastructure
Swiss Tropical and Public Health Institute, University of Basel, Prof. Nicole Probst Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
Duke University, Prof. Christopher Granger United States of America (North America)
- in-depth/constructive exchanges on approaches, methods or results

Scientific events

Active participation

Title Type of contribution Title of article or contribution Date Place Persons involved
Tag der Klinischen Forschung Poster Swiss Atrial Fibrillation Cohort Study (Swiss-AF): structural brain damage and cognitive decline among patients with atrial fibrillation 25.01.2018 Basel, Switzerland Osswald Stefan; Stippich Christoph; Sticherling Christian; Monsch Andreas; Kühne Michael; Aeschbacher Stefanie; Bonati Leo;
Tag der Klinischen Forschung Poster Cognitive function correlates with CHA2DS2-VASc score in patients with atrial fibrillation – The Swiss Atrial Fibrillation Cohort Study 25.01.2018 Basel, Switzerland Stippich Christoph; Shah Dipen C.; Sticherling Christian; Monsch Andreas; Beer Hans-Jürg; Osswald Stefan; Kühne Michael; Bonati Leo;
Congress of the Swiss Society of Cardiology (SGK) Talk given at a conference Cognitive function in patients with atrial fibrillation – the Swiss atrial fibrillation cohort study 07.06.2017 Baden, Switzerland Kühne Michael; Osswald Stefan;
Congress of the Swiss Society of Cardiology (SGK) Talk given at a conference Oral anticoagulation in patients with atrial fibrillation - insights from the Swiss Atrial fibrillation cohort study (Swiss-AF) 07.06.2017 Baden, Switzerland Kühne Michael; Osswald Stefan;
Congress of the European Society of Cardiology (ESC) Poster Symptoms and Health Perception in Atrial Fibrillation Patients from the Swiss Atrial Fibrillation Cohort Study (Swiss-AF) 03.04.2017 Barcelona, Spain Auricchio Angelo; Schläpfer Jürg; Aeschbacher Stefanie; Osswald Stefan; Ammann Peter; Shah Dipen C.; Erne Paul;
Congress of the European Society of Cardiology (ESC) Poster Cognitive function correlates with CHA2DS2-VASc score in patients with atrial fibrillation: The Swiss atrial fibrillation cohort study. 03.04.2017 Barcelona, Spain Sticherling Christian; Osswald Stefan; Beer Hans-Jürg; Shah Dipen C.; Stippich Christoph; Monsch Andreas; Bonati Leo; Kühne Michael;
Deutsche Gesellschaft für Kardiologie (DGK) Herztage Poster Employment status in a cohort of patients with atrial fibrillation 12.01.2017 Berlin, Germany Beer Hans-Jürg; Osswald Stefan; Bonati Leo; Szucs Thomas; Shah Dipen C.; Witassek Fabienne; Springer Anne;


Communication with the public

Communication Title Media Place Year
New media (web, blogs, podcasts, news feeds etc.) Swiss Atrial Fibrillation Cohort Italian-speaking Switzerland German-speaking Switzerland Western Switzerland 2016

Associated projects

Number Title Start Funding scheme
172676 Neuropsychiatric outcomes, muscular function and exploration of metabolic pathways disrupted in subclinical thyroid dysfunction: a prospective evaluation and impact of treatment 01.07.2017 Project funding (Div. I-III)
133681 Role of Inflammation, Oxidative Stress and Fibrosis in the Initiation and Progression of Human Atrial Fibrillation 01.07.2011 SNSF Professorships
159322 Risk Factors and Outcomes Associated With the Progression of Human Atrial Fibrillation 01.07.2015 SNSF Professorships
177520 Swiss Atrial Fibrillation Cohort Study 01.04.2018 Cohort Studies Large
176178 Health Consequences of the Burden of Atrial Fibrillation - The Swiss-AF-Burden study 01.10.2018 Project funding (special)
182328 “RedOmen II”: New Strategies to Reverse Plt Activation in the Aging (The NESTOR Project) 01.10.2018 Project funding (special)
173007 Patient selection and additive ablation strategy beyond pulmonary vein isolation for paroxysmal atrial fibrillation 01.09.2017 Project funding (Div. I-III)

Abstract

Specific aims:1. To increase our current knowledge on structural brain changes and neurological outcomes in AF patients: 1a. To gain additional insights on the incidence, morphological correlates and underlying mechanisms of cognitive decline in patients with AF 1b. To improve long term risk prediction for stroke and systemic embolism in contemporary AF patients using clinical, biomarker and genetic data 1c. To assess the incidence of subclinical brain damage on brain magnetic resonance imaging (bMRI) in AF patients2. To assess risk factors and subsequent outcomes associated with AF progression3. To build a comprehensive prediction model for arrhythmia recurrence after PVIStudy Design: Prospective, multicenter cohort study among patients with documented AF in Switzerland (12 centers)Target sample size: 4000 (n=2400 new patients for advanced imaging analyses, n=1600 additional patients from BEAT-AF feasibility cohort)Procedures: Study questionnaire, clinical examination, blood samples (incl. genetics) for biobanking, advanced 12-lead EKG, bMRI, Cognitive assessments, disability, cost, quality of life. Follow-up: Yearly clinical follow-up, covariate update, 12-lead EKG, cognitive assessments and outcome evaluations. bMRI and blood sampling will be repeated after 2 years in all patients.Main clinical outcome measures:- Death, stroke, systemic embolism, hospitalisation for heart failure, myocardial infarction, any unplanned hospitalization, major bleedingOther important evaluations will include the following: - change in cognitive function over time- new MRI findings at 2 years of follow-up- Cost analyses- Genetic analysesPreliminary results: 1129 AF patients have been enrolled in a feasibility cohort across 8 centers throughout Switzerland (BEAT-AF), with establishment of a web-based database, a biobank and complete long-term follow-up (follow-up rate >99% for morbidity/mortality and >95% for yearly questionnaire updates). Impact: By establishing a national, comprehensive and interdisciplinary AF network, this application is highly responsive to the current SNSF call for longitudinal studies and has the unique potential to provide important novel insights on disease progression and outcomes in patients with AF. The main focus on cognitive function and neurological complications is of major public health importance. Several major unmet clinical needs that will provide clinicians with better tools to take care of this growing patient population will be addressed. The current project also has a great potential to identify novel treatment targets for several important and currently unresolved public health problems, including AF, cognitive dysfunction or stroke. Detailed cost assessments will help to define more efficient patient care that will lead to less disability and reduced costs for the society as a whole.
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