Search

Background For the majority of patients with atrial fibrillation (AF), disease management has improved in recent years. However, there are still populations underrepresented or excluded in current registries and randomized controlled trials. HERA‐FIB (Heidelberg Registry of Atrial Fibrillation) was planned to assess real‐world evidence for the prevalence, demographic characteristics and management of patients with the diagnosis of AF presenting consecutively to a chest pain unit. Methods and Results HERA‐FIB is a retrospective, observational, single‐center study on patients with a diagnosis of AF presenting to a chest pain unit from June 2009 until March 2020. This article describes the structure, governance, outcome assessment, quality and data collection processes of the registry. Additionally, characteristics of populations of special interest are described. The study consecutively enrolled 10 222 patients presenting with AF to the chest pain unit of the University Hospital of Heidelberg. Clinical parameters and patient characteristics were assessed retrospectively. Outcome parameters included rates for all‐cause death, stroke, myocardial infarction and major bleedings. We were able to investigate patient cohorts of special interest such as advanced chronic kidney disease, octogenarians, and those with acute coronary syndrome who are often underrepresented in current studies and randomized controlled trials. Conclusions HERA‐FIB is one of the largest real‐world single‐center retrospective registries on patients with AF, which captures the era of transition from vitamin K antagonists to non–vitamin K oral anticoagulation regimens in clinical practice and offers the possibility to investigate patient populations usually underrepresented or excluded in current available randomized controlled trials and registries. Registration URL: https://www.clinicaltrials.gov; unique identifier: NCT05995561.

Background Management of patients with non–ST‐segment–elevation acute coronary syndrome (NSTE‐ACS) is based on 2020 European Society of Cardiology guidelines, which recommend the preferential use of prasugrel over ticagrelor. Because the selection of the respective P2Y12 inhibitor has to consider label restrictions, we sought to evaluate the proportion of patients qualifying for either ticagrelor or prasugrel and reasons for noneligibility in an unselected cohort of patients with acute coronary syndrome. Methods and Results In this retrospective observational study, patients with ST‐segment–elevation myocardial infarction (STEMI) or NSTE‐ACS presenting consecutively during a 24‐month period were enrolled. The eligibility of patients for a dual antiplatelet therapy option was assessed retrospectively. A total of 1502 patients had confirmed acute coronary syndrome (287 STEMI and 1215 NSTE‐ACS). Eligibility for ticagrelor and full‐dose prasugrel differed significantly for STEMI and NSTE‐ACS (93% versus 51%, P