title: Management and 1-year outcomes of patients with atrial fibrillation in the Middle East: Gulf survey of atrial fibrillation events.
abstract: 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.
authors.affiliation: Department of Medicine, Faculty of Medicine, Kuwait University, Safat, Kuwait zubaid@hsc.edu.kw.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Zubaid
authors.affiliation: Department of Medicine, Mubarak Al-Kabeer Hospital, Ministry of Health, Jabriya, Kuwait.
authors.forename: Wafa A
authors.initials: WA
authors.lastname: Rashed
authors.affiliation: Heart and Vascular Institute, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates Department of Medicine, Tufts Clinical and Translational Science Institute, Tufts Medical Center and Tufts University School of Medicine, Boston, MA, USA.
authors.forename: Alawi A
authors.initials: AA
authors.lastname: Alsheikh-Ali
authors.affiliation: Department of Pharmacology & Clinical Pharmacy, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman Gulf Health Research, Muscat, Oman.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Al-Zakwani
authors.affiliation: Heart and Vascular Institute, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates.
authors.forename: Wael
authors.initials: W
authors.lastname: AlMahmeed
authors.affiliation: Department of Medicine, Faculty of Medicine, UAE University, Al-Ain, United Arab Emirates.
authors.forename: Abdullah
authors.initials: A
authors.lastname: Shehab
authors.affiliation: Department of Medicine, Royal Hospital, Muscat, Oman.
authors.forename: Kadhim
authors.initials: K
authors.lastname: Sulaiman
authors.affiliation: Department of Medicine, Al Thawra Hospital, Sana'a, Yemen.
authors.forename: Ahmed Al
authors.initials: AA
authors.lastname: Qudaimi
authors.affiliation: Department of Cardiology and Cardiovascular Surgery, Hamad Medical Corporation, Doha, Qatar.
authors.forename: Nidal
authors.initials: N
authors.lastname: Asaad
authors.affiliation: Department of Cardiology, Mohammed Bin Khalifa Cardiac Centre, Manama, Bahrain.
authors.forename: Haitham
authors.initials: H
authors.lastname: Amin
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D016009:Chi-Square Distribution; D015897:Comorbidity; D004636:Emergency Service, Hospital; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D002546:Ischemic Attack, Transient / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D008877:Middle East / Q000453:epidemiology; D015999:Multivariate Analysis; D016017:Odds Ratio; D010351:Patient Discharge; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D011446:Prospective Studies; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D013997:Time Factors; D016896:Treatment Outcome; D014859:Warfarin / Q000627:therapeutic use*
chemical_list: D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors; D014859:Warfarin
keywords: Middle East; anticoagulation; atrial fibrillation; risk assessment; stroke