Prevalence of atrial fibrillation in the Malaysian communities

Lim, C.W.; Kasim, Sazzli; Ismail, J.R.; Chua, N.Y.C.; Khir, R. Najme; Zainal, H.A.; Rahman, E. Abdul; Arshad, Mohd Fadzil; Othman, Zubin Ibrahim; Yusoff, Khalid

doi:10.1136/heartasia-2016-010775

Cited by 23 publications

(16 citation statements)

References 27 publications

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“…Epidemiological transition and higher prevalence of CV risk factors in developing countries are the plausible causes to higher rate of ischemic related heart failure in our population [ 8 , 9 ]. Younger age group in our study also explains the lower rate of atrial fibrillation, which agrees with the recent Malaysian AF data [ 10 ]. Patients in our study presented with more severe symptoms compare to the past Malaysia data.…”

Section: Discussionsupporting

confidence: 92%

Acute decompensated heart failure in a non cardiology tertiary referral centre, Sarawak General Hospital (SGH-HF)

Ling

Chung

Chua

et al. 2020

BMC Cardiovasc Disord

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Background Data on clinical characteristics of acute decompensated heart failure (ADHF) in Malaysia especially in East Malaysia is lacking. Methods This is a prospective observational study in Sarawak General Hospital, Medical Department, from October 2017 to September 2018. Patients with primary admission diagnosis of ADHF were recruited and followed up for 90 days. Data on patient’s characteristics, precipitating factors, medications and short-term clinical outcomes were recorded. Results Majority of the patients were classified in lower socioeconomic group and the mean age was 59 years old. Hypertension, diabetes mellitus and dyslipidaemia were the common underlying comorbidities. Heart failure with ischemic aetiology was the commonest ADHF admission precipitating factor. 48.6% of patients were having preserved ejection fraction HF and the median NT-ProBNP level was 4230 pg/mL. Prescription rate of the evidence-based heart failure medication was low. The in-patient mortality and the average length of hospital stay were 7.5% and 5 days respectively. 43% of patients required either ICU care or advanced cardiopulmonary support. The 30-day, 90-day mortality and readmission rate were 13.1%, 11.2%, 16.8% and 14% respectively. Conclusion Comparing with the HF data from West and Asia Pacific, the short-term mortality and readmission rate were high among the ADHF patients in our study cohort. Maladaptation to evidence-based HF prescription and the higher prevalence of cardiovascular risk factors in younger patients were among the possible issues to be addressed to improve the HF outcome in regions with similar socioeconomic background.

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Section: Discussionsupporting

confidence: 92%

Acute decompensated heart failure in a non cardiology tertiary referral centre, Sarawak General Hospital (SGH-HF)

Ling

Chung

Chua

et al. 2020

BMC Cardiovasc Disord

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“…The Malaysian prevalence of AF (7.3%) was lower in comparison to the ASIAN-HF cohort. This study's findings are consistent with other Malaysianbased datasets, such as that of Lim et al, 13 in which overall prevalence of AF was 0.54%, lower than the global average of 1.00%. 13 Also noted was that this study's average LVEF was much lower (33.7±9.3%) than compared with Inter-CHF (28.0%), likely due to the heavy ischaemic burden noted in the Malaysian population which is greatly linked to heart failure with a reduced ejection fraction phenotype.…”

Section: Comparison Between Registriessupporting

confidence: 92%

“…This study's findings are consistent with other Malaysianbased datasets, such as that of Lim et al, 13 in which overall prevalence of AF was 0.54%, lower than the global average of 1.00%. 13 Also noted was that this study's average LVEF was much lower (33.7±9.3%) than compared with Inter-CHF (28.0%), likely due to the heavy ischaemic burden noted in the Malaysian population which is greatly linked to heart failure with a reduced ejection fraction phenotype. 14 When compared to the Inter-CHF group, despite lower left ventricular systolic function, mean systolic and diastolic blood pressure were roughly 10 and 5 mmHg higher, respectively, in this study's cohort.…”

Section: Comparison Between Registriessupporting

confidence: 92%

Cross-Sectional Study of Ethnicity and Chronic Heart Failure: Complex Interplay of Health and Wealth

Abidin¹,

Shariff²,

Kasim³

2020

EMJ

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Objectives: Extrapolating data from international and regional registries on chronic heart failure provides a challenge in Malaysia in view of it being a multicultural country. This study aimed to illustrate the chronic heart failure landscape within northern Kuala Lumpur and identify differences amongst major ethnic groups. Methods: A retrospective, single-centre study was conducted between the 1st January 2013 and 30th April 2016. Patients with left ventricular ejection fraction ≤45% were identified and information was collected on these individuals’ demographics, risk factors, and aetiology. Comparisons were made between three major ethnic groups within Malaysia, and between the author’s database and that of other international registries. Results: 1,181 patients were identified, the majority being Malays (67.3%) and male (81.2%). The mean age was 58.2±11.7 years. The majority had ischaemic risk factors, including previous and current smoking habits (56.7%), coronary artery disease (66.1%), hypertension (71.2%), diabetes (61.8%), and dyslipidaemia (47.9%). There were significant differences noted when looking at rates of dyslipidaemia, diabetes, atrial fibrillation, and chronic kidney disease amongst different ethnicities. The mean left ventricular ejection fraction in Malays was lower (33.1±9.6%) compared to that of Chinese (34.7±8.7%) and Indians (34.9±8.3%). There was marked differences seen in this study’s cohort, compared to three major Asian registries: The 2003 Chong et al. registry, Inter-CHF, and ASIAN-HF. Conclusion: There exists great disparity in chronic heart failure burden amongst populations, and therefore local registries are needed to narrow the gap in knowledge regarding chronic heart failure within Malaysia.

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“…The prevalence of AF in the Malaysian population is estimated at 0.54%, based on a prevalence study conducted between 2007 and 2014. 1 Risk of stroke for AF patients is two to seven times higher than healthy population. [2][3][4] Warfarin is an effective oral anticoagulant and it can reduce the risk of stroke in AF patients by 64%.…”

Section: Introductionmentioning

confidence: 99%

“…Atrial fibrillation (AF) is the most common type of cardiac arrhythmia seen in clinical practice worldwide. The prevalence of AF in the Malaysian population is estimated at 0.54%, based on a prevalence study conducted between 2007 and 2014 1 . Risk of stroke for AF patients is two to seven times higher than healthy population 2‐4 .…”

Section: Introductionmentioning

confidence: 99%

Estimation of direct medical costs of warfarin, dabigatran and rivaroxaban treatments in non‐valvular atrial fibrillation patients in a tertiary public hospital, Malaysia

Tan

Looi

Yeo

2020

Pharmacy Practice and Res

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Background: Non-vitamin K antagonist oral anticoagulants (NOACs) are effective alternatives to warfarin for stroke prevention in non-valvular atrial fibrillation (NVAF) patients. However, concerns have arisen due to their higher costs than warfarin. Aim: To estimate and compare the total direct medical costs of warfarin, dabigatran and rivaroxaban treatments in NVAF patients in Penang general hospital. Methods: This was a retrospective study capturing one year of data from January to December 2015. The data were extracted from hospital records. The total direct medical costs, including any costs associated with treatment-related complications, were calculated as the sum of drug acquisition cost, INR point-of-care testing cost, personnel cost and treatment-related complications cost. Descriptive statistical analysis was performed to describe the results. Results: A total of 224 patients (warfarin, n = 122; dabigatran, n = 63; rivaroxaban, n = 39) were recruited. The total direct medical costs including cost of any treatment-related complications for warfarin ranged from MYR1269.77 to MYR2383.35. The total direct medical costs with treatment-related complications for dabigatran and rivaroxaban were MYR3469.18 and MYR2883.35, respectively. During the study period, one ischaemic stroke (0.82%) and three major bleeding events (2.46%) were observed in the warfarin group, whereas only one patient (1.59%) in the dabigatran group experienced minor bleeding. Drug acquisition costs for NOACs were high, which accounted for 80% of the total direct medical costs in the dabigatran group. However, the direct medical costs for warfarin increased by 4-fold when treatment-related complications costs were included. Conclusion: The direct medical costs of NOACs were relatively higher than warfarin, however, the incidence of major bleeding was higher in the warfarin group.

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Prevalence of atrial fibrillation in the Malaysian communities

Abstract: The prevalence of AF in the Malaysian population was low at 0.54% compared to the global average of 1%. We found that AF was associated with older age, male sex, hypertension, and ischaemic heart disease.

Cited by 23 publications

References 27 publications

Acute decompensated heart failure in a non cardiology tertiary referral centre, Sarawak General Hospital (SGH-HF)

Acute decompensated heart failure in a non cardiology tertiary referral centre, Sarawak General Hospital (SGH-HF)

Cross-Sectional Study of Ethnicity and Chronic Heart Failure: Complex Interplay of Health and Wealth

Estimation of direct medical costs of warfarin, dabigatran and rivaroxaban treatments in non‐valvular atrial fibrillation patients in a tertiary public hospital, Malaysia

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