[Antithrombotiques oraux et pronostic après un an des patients atteints de fibrillation auriculaire dans un milieu à ressources limitées].

Oral antithrombotic therapy and one-year clinical outcomes among patients with atrial fibrillation in resource-limited settings.

Publisher: Elsevier Country of Publication: France NLM ID: 0142167 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1768-3181 (Electronic) Linking ISSN: 00033928 NLM ISO Abbreviation: Ann Cardiol Angeiol (Paris) Subsets: MEDLINE

Publication: Paris : Elsevier
Original Publication: Paris, Expansion scientifique française.

Atrial Fibrillation*/diagnosis ; Atrial Fibrillation*/drug therapy ; Atrial Fibrillation*/complications ; Heart Failure*/diagnosis ; Heart Failure*/drug therapy ; Heart Failure*/complications ; Stroke*/etiology ; Stroke*/prevention & control ; Stroke*/epidemiology; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Anticoagulants/therapeutic use ; Cameroon ; Hemorrhage/chemically induced ; Hemorrhage/epidemiology ; Prospective Studies ; Risk Factors ; Young Adult ; Adult

Background: Atrial fibrillation is associated with increased risk of morbidity and mortality. There's limited data on the outcomes of atrial fibrillation patients in Africa. We aimed at evaluating the clinical outcomes and their associated factors in patients with atrial fibrillation on antithrombotic therapy in Douala.
Methods: The Douala atrial fibrillation registry is a prospective, observational cohort study of patients with atrial fibrillation followed by cardiovascular specialists in 3 specialized care centres. From January to April 2018, all patients with electrocardiographic diagnosis of atrial fibrillation, aged 21 years or older, were included in the registry provided their consent. The composite endpoint of heart failure, stroke, major bleeding, hospitalisation and mortality as well as their individual occurrence were assessed at 12 months.
Results: Of 113 participants that were included, 6(5.3%) were lost to follow-up. The mean age was 70 ± 12 years, with a female predominance (68%). After a mean follow-up time of 12.2 ± 0.7 months, 51 patients (47.7%) had at least one outcome. Hospitalisation, all-cause mortality, heart failure, stroke and major bleeding rates were 33.3%, 16.8%, 15.2%, 4.8% and 2.9% respectively. There was no significant difference in the composite outcome and mortality according to the antithrombotic treatment. Previous heart failure [aHR = 3.07, 95% CI (1.48-6.36) p = 0.003], new onset atrial fibrillation [aHR= 4.00, 95% CI (0.96-8.19) p < 0.001] and paroxystic atrial fibrillation [aHR= 3.74, 95% CI (1.33-10.53) p = 0.013] were significant predictors of outcome.
Conclusion: Half of patients with atrial fibrillation in this registry developed an outcome after one year of follow-up, with heart failure, new onset and paroxystic atrial fibrillation being the main predicting factors. Diagnosing and managing atrial fibrillation in patients with heart disease should therefore be considered as a key priority.
Competing Interests: Declaration of Competing Interest The authors declare that they have no competing interest.
(Copyright © 2023 Elsevier Masson SAS. All rights reserved.)

Keywords: Antithrombotic treatment; Atrial fibrillation; Fibrillation auriculaire; Heart failure; Stroke, Resource-limited setting; accident vasculaire cérébral; insuffisance cardiaque; milieu à ressources limitées; traitement antithrombotique

0 (Anticoagulants)

Date Created: 20230618 Date Completed: 20231025 Latest Revision: 20231025

20231215

10.1016/j.ancard.2023.101616

37331159