Vol.:(0123456789) 1 3 European Geriatric Medicine https://doi.org/10.1007/s41999-018-0026-6 RESEARCH PAPER Evaluating the efectiveness and risks of oral anticoagulant treatments in multimorbid frail older subjects with atrial fbrillation using the multidimensional prognostic index: the EURopean study of older subjects with atrial fbrillation—EUROSAF Nicola Veronese 1  · Alessandra Argusti 2  · Elisabetta Canepa 1  · Maria Cristina Polidori 3  · Stefania Maggi 4  · Timo Strandberg 5,6  · Alberto Pilotto 1  on behalf of EUROSAF Study Investigators Received: 15 September 2017 / Accepted: 9 January 2018 © European Geriatric Medicine Society 2018 Abstract Background Previous studies suggested that a diferent risk of mortality may infuence the oral anticoagulant prescription in older patients with atrial fbrillation (AF). Recently, the Multidimensional Prognostic Index (MPI) demonstrated a high grade of accuracy, calibration and feasibility to predict mortality in hospitalized and community-dwelling older people. Prognostic information, as calculated by the MPI, however, is not included in the decision algorithm of treatments in older patients with AF Purpose The aim of this international multicenter prospective observational study was to evaluate whether a diferent prog- nostic profle, as determined by the MPI, is associated with diferent treatments for AF (no treatment vs oral anticoagulants) and diferences in the main outcomes, i.e., mortality, major thromboembolic events and side efects. Materials and methods Older hospitalized patients (age ≥ 65 years) with non-valvular AF will be consecutively enrolled in an European, cross-national, prospective, observational study. At baseline, functional and clinical information will be collected to calculate the MPI, CHA2DS2-VASc score, HAS-BLED score, pharmacological treatments (and the compliance during follow-up) and main and secondary diagnoses. During the 12-month follow-up period, information on survival, major thromboembolic events and major bleeding will be collected. For these aims, a sample size of 3000 people was deemed as sufcient. Conclusions The EUROSAF study has the main objective of evaluating in a population of hospitalized older subjects with AF the clinical beneft/risk ratio of the oral anticoagulant treatments in terms of mortality, major thromboembolic events and bleeding side-efects, giving important information regarding the appropriate prescription of anticoagulant therapy in this population. ClinicalTrials.gov Identifer NCT02973984. Keywords Atrial Fibrillation · Muldimensional Prognostic Index · Frailty · Elderly · Anticoagulants The members of the EUROSAF Study Investigators are listed in acknowledgements section. * Alberto Pilotto alberto.pilotto@galliera.it 1 Geriatrics Unit, Department of Geriatric Care, OrthoGeriatrics and Rehabilitation, Frailty Area, E.O. Galliera Hospital, National Relevance and High Specialization Hospital, Genoa 16128, Italy 2 Scientifc Coordination Unit, E.O. Galliera Hospital, National Relevance and High Specialization Hospital, Genoa, Italy 3 Ageing Clinical Research, Department Medicine II, University Hospital of Cologne, Cologne, Germany 4 Neuroscience Section, EUGMS President and National Research Council, Padua, Italy 5 University of Helsinki and Helsinki University Hospital, Helsinki, Finland 6 Center for Life Course Health Research, University of Oulu, Oulu, Finland