Primary Outcomes

Description: Plasma concentrations of dabigatran, rivaroxaban or apixaban will be measured using High Performance Liquid Chromatography (HPLC) coupled with tandem mass spectrometry (MS/MS). Blood samples will be taken in an EDTA tube and rapidly centrifugated. Plasma will be aliquoted and frozen at minus 80 degrees Celsius for later analysis.

Measure: Measurement of plasma concentrations of new oral anticoagulant agents

Time: 0 days (at inclusion)

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Description: To investigate the existence of a relation between polymorphisms of ABCB1 and plasma concentrations of new oral anticoagulants, the SNaPshot® Multiplex System will be used enabling multiplexing of SNPs (single nucleotide polymorphisms) of the ABCB1 gene (namely rs4148738, rs2235046, rs1128503, rs10276036, rs1202169, rs1202168, rs1202167).

Measure: Identification of polymorphisms of the gene ABCB1 coding for P-gp

Time: 0 days (at inclusion)

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Primary Outcomes

Description: Incidence of heart failure or asymptomatic decline in left-ventricular ejection fraction (LVEF) by >10% in patients whose LVEF is ≥50% or LVEF drop ≥5% in those with a decrease to <50% (primary outcome measure)

Measure: Rate of asymptomatic and symptomatic cardiac dysfunction

Time: 1 year

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Description: Reversible LVEF decline to within 5% of baseline (secondary primary outcome measure)

Measure: Rate of reversible cardiac function decline

Time: 1 year

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Secondary Outcomes

Description: Delta change in LVEF from completion to one year after completion of trastuzumab-based HER2-directed therapy

Measure: Cardiac function changes after completion of HER2-directed therapy

Time: 1 year

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Description: Correlation of absolute delta change in GLS and LVEF while on trastuzumab and after stopping trastuzumab with the frequency of the following SNPs: trastuzumab-related: p<1x10-5 hits from Norton GWAS (six loci) 130 HER 2 Ile665Val, HER2 Pro1170Ala125, 126, 130, anthracycline-related: ABCB1 rs1128503, ABCB4 rs1149222, ABCC1 rs45511401, ABCC2 res17222723, CAT rs10836235, CBR3 rs1056892, CYBA rs4673, CYP3A4*22 rs35599367, NCF4 rs1883112, RAC2 rs13058338, RARG rs2229774, SLC28A3 rs7853758, TOP2B rs10865801, and UGT 1A6*4 rs1786378374, 150-152, beta-blocker-related: β2-AR Gln27Gln, β1-AR Arg389Arg 80-82 and CYP2D6 polymorphisms (CYP2D6 alleles (*1, *2, *3, *4, *5, *6, *7, *8, *9, *10, *11, *15, *17, *19, *20, *29, *35, *36, *40 and *41), as well as 7 CYP2D6 gene duplications (*1 9 N, *2 9 N, *4 9 N, *10 9 N, *17 9 N, *35 9 N and *41 9 N) by use of the AmpliChip CYP450 GeneChip

Measure: Gene variants and risk of cardiotoxicity and response to therapy

Time: 2 years

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Primary Outcomes

Description: Total number of AF cases newly diagnosed during the study period.

Measure: Total number of AF cases newly diagnosed during the study period.

Time: Through study completion, an average of 1 year

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Description: Number of patients who, for the first time ever, were assigned to anticoagulation therapy.

Measure: Number of patients who, for the first time ever, were assigned to anticoagulation therapy.

Time: Through study completion, an average of 1 year

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Description: Assessed using data obtained from pharmacokinetic analysis. International normalised ratio (INR) - target range from 2 to 3.

Measure: Compliance to anticoagulation therapy for warfarin.

Time: 6 months after administration of anticoagulants

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Description: Assessed using data obtained from pharmacokinetic analysis. Quantitative determination of the concentration of drugs in the blood (blood sampling three hours after taking the drug).

Measure: Compliance to anticoagulation therapy for new oral anticoagulants.

Time: 6 months after administration of anticoagulants

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Description: Evaluated as incremental cost-effectiveness ratio of screening per quality adjusted life year gained, and per stroke avoided.

Measure: Cost-effectiveness of using the single-lead CardioQVARK ECG device in screening for AF in primary health care.

Time: Through study completion, an average of 1 year

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Secondary Outcomes

Description: Mean time to diagnosis.

Measure: Mean time to diagnosis.

Time: Through study completion, an average of 1 year

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Description: Number of patients with a CHA₂DS₂-VASc score (the CHA2DS2-VASc Score is the most commonly utilized method to predict thromboembolic risk in atrial fibrillation) of ≥ 1.

Measure: Number of patients with a CHA₂DS₂-VASc score (the CHA2DS2-VASc Score is the most commonly utilized method to predict thromboembolic risk in atrial fibrillation) of ≥ 1.

Time: Through study completion, an average of 1 year

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Description: Number of patients with a CHA₂DS₂-VASc score (the CHA2DS2-VASc Score is the most commonly utilized method to predict thromboembolic risk in atrial fibrillation) of ≥ 2.

Measure: Number of patients with a CHA₂DS₂-VASc score (the CHA2DS2-VASc Score is the most commonly utilized method to predict thromboembolic risk in atrial fibrillation) of ≥ 2.

Time: Through study completion, an average of 1 year

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Description: Defined as frequency of ischemic stroke or transient ischemic attack in patients with newly diagnosed AF and assigned anticoagulants.

Measure: Incidence of ischemic stroke or transient ischemic attack after enrollment in the study.

Time: Through study completion, an average of 1 year

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Description: Defined as frequency of massive hemorrhage in patients with newly diagnosed AF and assigned anticoagulants.

Measure: Incidence of massive hemorrhage after enrollment in the study.

Time: Through study completion, an average of 1 year

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Description: Defined as frequency of hemorrhagic stroke in patients with newly diagnosed AF and assigned anticoagulants.

Measure: Incidence of hemorrhagic stroke after enrollment in the study.

Time: Through study completion, an average of 1 year

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Description: For warfarin - CYP2C9 (CYP2C9 * 2, CYP2C9 * 3), VKORC1 (1 marker), CYP4F2 (1 marker), GGCX (1 marker). For new oral anticoagulants - rs2244613 of the gene CES1, rs1045642 (C3435T), rs1128503 (C1236T), rs2032582 (G2677T / А) of the gene ABCB1, rs2231142 (С421А, Q141K) of the gene ABCG2, rs776746 (A6986G * 399 CYP3 CYP3) CYP3A4.

Measure: Pharmacogenetic testing by polymorphic markers

Time: 6 months after administration of anticoagulants

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