Management and 1-year outcomes of patients with atrial fibrillation in the Middle East: Gulf survey of atrial fibrillation events

• Published in: Angiology Vol. 66; no. 5; p. 464
• Main Authors: Zubaid, Mohammad, Rashed, Wafa A, Alsheikh-Ali, Alawi A, Al-Zakwani, Ibrahim, AlMahmeed, Wael, Shehab, Abdullah, Sulaiman, Kadhim, Qudaimi, Ahmed Al, Asaad, Nidal, Amin, Haitham
• Format: Journal Article
• Language: English
• Published: United States 01.05.2015
• Subjects: Adult; Age Factors; Aged; Anticoagulants - therapeutic use; Atrial Fibrillation - diagnosis; Atrial Fibrillation - epidemiology; Atrial Fibrillation - therapy; Chi-Square Distribution; Comorbidity; Emergency Service, Hospital; Female; Guideline Adherence; Humans; Ischemic Attack, Transient - diagnosis; Ischemic Attack, Transient - epidemiology; Ischemic Attack, Transient - prevention & control; Logistic Models; Male; Middle Aged; Middle East - epidemiology; Multivariate Analysis; Odds Ratio; Patient Discharge; Platelet Aggregation Inhibitors - therapeutic use; Practice Guidelines as Topic; Practice Patterns, Physicians; Prospective Studies; Registries; Risk Assessment; Risk Factors; Stroke - diagnosis; Stroke - epidemiology; Stroke - prevention & control; Time Factors; Treatment Outcome; Warfarin - therapeutic use; Middle East; Middle East; risk assessment; atrial fibrillation; stroke; anticoagulation
• DOI: 10.1177/0003319714536980

We describe management and outcomes of patients with nonvalvular atrial fibrillation (AF) in the Middle East. Consecutive patients with AF presenting to emergency departments (EDs) were prospectively enrolled. Among 1721 patients with nonvalvular AF, mean age was 59 ± 16 years and 44% were women. Comorbidities were common such as hypertension (59%), diabetes (33%), and coronary artery disease (33%). Warfarin was not prescribed to 40% of patients with Congestive heart failure, Hypertension, Age, Diabetes mellitus, Stroke/TIA2 score of ≥2. One-year rates of stroke/transient ischemic attack (TIA) and all-cause mortality were 4.2% and 15.3%, respectively. Warfarin use at hospital-ED discharge was independently associated with lower 1-year rate of stroke/TIA (odds ratio [OR], 0.38; 95% confidence interval [CI], 0.17-0.85; P = .015) and all-cause mortality (OR, 0.51; 95% CI, 0.32-0.83; P = .006). Prior history of heart failure and peripheral vascular disease was independent mortality predictors. Our patients are relatively young with significant cardiovascular risk. Their anticoagulation treatment is suboptimal, and 1-year all-cause mortality and stroke/TIA event rates are relatively high.