title: The Italian START-Register on Anticoagulation with Focus on Atrial Fibrillation.
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 CHADS2 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.
authors.affiliation: Department of Experimental and Clinical Medicine, Thrombosis Centre, University of Florence, Florence, Italy.
authors.forename: Emilia
authors.initials: E
authors.lastname: Antonucci
authors.affiliation: Department of Heart and Vessels, Thrombosis Centre, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Poli
authors.affiliation: Department of Hematology, Vicenza S. Bortolo Hospital, Vicenza, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Tosetto
authors.affiliation: Department of Clinical Cardiology, Thrombosis Centre, University of Padua, Padua, Italy.
authors.forename: Vittorio
authors.initials: V
authors.lastname: Pengo
authors.affiliation: Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
authors.forename: Armando
authors.initials: A
authors.lastname: Tripodi
authors.affiliation: Drug Evaluation Unit, WHO Collaborating Centre in Evidence-Based Research Synthesis and Guideline Development, Emilia Romagna Health and Social Care Agency, Bologna, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Magrini
authors.affiliation: Department of Medical Sciences, University Hospital of Cagliari, Cagliari, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Marongiu
authors.affiliation: Coordinator of the START-Register, Bologna, Italy.
authors.forename: Gualtiero
authors.initials: G
authors.lastname: Palareti
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000009:adverse effects*; D001281:Atrial Fibrillation / Q000139:chemically induced*; D015331:Cohort Studies; D003404:Creatinine / Q000378:metabolism; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D012042:Registries / Q000706:statistics & numerical data; D051437:Renal Insufficiency / Q000139:chemically induced; D012307:Risk Factors; D020521:Stroke / Q000139:chemically induced
chemical_list: D000925:Anticoagulants; D003404:Creatinine