The Cumulative Incidence of Stroke, Myocardial infarction, Heart Failure and Sudden Cardiac Death in Patients with Atrial Fibrillation

Naser, Nabil; Kulić, Mehmed; Dilić, Mirza; Džubur, Alen; Durak, Azra; Pepic, Esad; Smajić, Elnur; Kušljugić, Zumreta

doi:10.5455/medarh.2017.71.316-319

Cited by 16 publications

(13 citation statements)

References 26 publications

(15 reference statements)

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“…The Jordan AF study represents the first contemporary study that addresses management practices and major cardiovascular events after one-year of follow-up in a relatively large Middle Eastern cohort of patients enrolled in the era of an increasing utilization of the newer OACs to prevent stroke and SE. The principal findings of the study are as follows: (i) the majority of AF patients (9 of 10) had NVAF; (ii) the majority of patients with NVAF had high-risk CHA2DS2-VASc score (∼80%); and (iii) rates of incidence of major cardiovascular events at one-year of follow-up were comparable to those reported by studies from other regions in the world [ 22 – 24 ].…”

Section: Resultssupporting

confidence: 61%

One-Year Clinical Outcome in Middle Eastern Patients with Atrial Fibrillation: The Jordan Atrial Fibrillation (JoFib) Study

Hammoudeh

Khader

Tabbalat

et al. 2022

International Journal of Vascular Medicine

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Background. Prevention of stroke and systemic embolism (SE) prevention in patients with atrial fibrillation (AF) has radically changed in recent years. Data on contemporary utilization of oral anticoagulants (OACs) and cardiovascular outcome in Middle Eastern patients with AF are needed. Methods. The Jordan atrial fibrillation (JoFib) study enrolled consecutive patients with AF in Jordan from May 2019 through October 2020 and were followed up for one year after enrollment. Results. Overall, 2020 patients were enrolled. The mean age was 67.9 + 13.0 years. Nonvalvular (NVAF) was diagnosed in 1849 (91.5%) patients. OACs were used in 85.7% of high-risk patients with NVAF (CHA2DS2-VASc score>3 in women, and>2 in men), including direct OACs (DOACs) in 64.1% and vitamin K antagonists (VKA) in 35.9%. Adherence rate to the use of the same OAC agent was 90.6% of patients. One-year cardiovascular (CV) mortality was 7.8%, stroke/SE was 4.5%, and major bleeding events were 2.6%. Independent predictors for all-cause mortality in patients with NVAF were age>75 years, heart failure, major bleeding event, type 2 diabetes mellitus, study enrollment as an in-patient, and coronary heart disease. The use of OACs was associated with lower all-cause mortality. The strongest independent predictors for stroke/SE were high-risk CHA2DS2-VASc score and prior history of stroke. Conclusions. This study of Middle Eastern AF patients has reported high adherence to OACs. The use of OACs was associated with a lower risk for all-cause mortality. One-year rates of stroke and major bleeding events were comparable to those reported from other regions in the world.

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Section: Resultssupporting

confidence: 61%

One-Year Clinical Outcome in Middle Eastern Patients with Atrial Fibrillation: The Jordan Atrial Fibrillation (JoFib) Study

Hammoudeh

Khader

Tabbalat

et al. 2022

International Journal of Vascular Medicine

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“…Presence of persistent AF was associated with progressive heart failure (LVEF <35%). Large-scaled population-based studies demonstrated a higher incidence of SCD at long-term follow-up in AF patients 28,29 . Furthermore, virtually all risk prediction scores for primary preventive ICD therapy found AF to be a strong risk factor in patients with LVEF <35% 30,31 .…”

Section: Discussionmentioning

confidence: 96%

Atrial Fibrillation Is Associated with Increased Mortality in Patients Presenting with Ventricular Tachyarrhythmias

Behnes

Rusnak

Taton

et al. 2019

Sci Rep

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Heterogenous data about the prognostic impact of atrial fibrillation (AF) in patients with ventricular tachyarrhythmias exist. Therefore, this study evaluates this impact of AF in patients presenting with ventricular tachyarrhythmias. 1,993 consecutive patients presenting with ventricular tachyarrhythmias (i.e. ventricular tachycardia and fibrillation (VT, VF)) on admission at one institution were included (from 2002 until 2016). All medical data of index and follow-up hospitalizations were collected during the complete follow-up period for each patient. Statistics comprised univariable Kaplan-Meier and multivariable Cox regression analyses in the unmatched consecutive cohort and after propensity-score matching for harmonization. The primary prognostic endpoint was long-term all-cause mortality at 2.5 years. AF was present in 31% of patients presenting with index ventricular tachyarrhythmias on admission (70% paroxysmal, 9% persistent, 21% permanent). VT was more common (67% versus 59%; p = 0.001) than VF (33% versus 41%; p = 0.001) in AF compared to non-AF patients. Long-term all-cause mortality at 2.5 years occurred more often in AF compared to non-AF patients (mortality rates 40% versus 24%, log rank p = 0.001; HR = 1.825; 95% CI 1.548–2.153; p = 0.001), which may be attributed to higher rates of all-cause mortality at 30 days, in-hospital mortality and mortality after discharge (p < 0.05) (secondary endpoints). Mortality differences were observed irrespective of index ventricular tachyarrhythmia (VT or VF), LV dysfunction or presence of an ICD. In conclusion, this study identifies AF as an independent predictor of death in patients presenting consecutively with ventricular tachyarrhythmias.

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“…The two entities have a bidirectional relationship, and they share similar predisposing factors. The main pathophysiological mechanisms of hypertension-related AF include hypertension-induced LVH and subsequent LA enlargement and remodeling, while activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) also contribute to the development of AF (13) . AF during hypertension increases the risk of thromboembolic complications and heart failure.…”

Section: Discussionmentioning

confidence: 99%

The Diagnostic Value of Combined 24-h BP and ECG Holter Monitoring in Detection of Cardiac Arrhythmias in Patients with Arterial Hypertension

Naser¹,

Pepi²,

Avdi³

2022

Acta Inform Med

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Background: Arrhythmias are common problems in hypertensive patients. The presence and complexity of both supraventricular and ventricular arrhythmias may influence morbidity, mortality, as well as the quality of life of patients. Objective: The aim of this study was to assess the diagnostic value of combined 24h BP and ECG Holter monitoring in detection of cardiac arrhythmias in patients with arterial hypertension. Methods: We analyzed the simultaneous records of combined 24h BP and ECG Holter monitoring for 356 adult patients with diagnosed arterial hypertension in the period from January 2017 until January 2021 year. The cardiac arrhythmias were classified in three main groups as following: a) Supraventricular arrhythmias; b) Ventricular arrhythmias; c) Bradyarrhythmia’s. Standard transthoracic echocardiograms were performed in order to evaluate signs of hypertensive or structural heart disease with focus on left ventricle hypertrophy and LV function. Results: Patients had a mean age of 64 ± 11years, 62% male. Average clinic BP was 153.4+18/87.5+14 mmHg. More than 46% of patients displayed a very high-risk profile. In all enrolled patients, cardiac arrhythmia was detected in 302 (84%) patients. The total number of patients with supraventricular arrhythmias was 153 (50,7%). Ventricular arrhythmias were detected in 98 (32,5%) patients. Bradyarrhythmia’s were detected in 51 (16,9%) patients. Elevated resting heart rate in sinus rhythm was detected in 87 (31,6%) of 275 patients with sinus rhythm. Conclusion: Most arrhythmias are related to longstanding arterial hypertension. Effective treatment of arterial hypertension plays important role in preventing structural and functional cardiac abnormalities which will contribute to the reduction of cardiac arrhythmias in hypertensive patients.

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The Cumulative Incidence of Stroke, Myocardial infarction, Heart Failure and Sudden Cardiac Death in Patients with Atrial Fibrillation

Cited by 16 publications

References 26 publications

One-Year Clinical Outcome in Middle Eastern Patients with Atrial Fibrillation: The Jordan Atrial Fibrillation (JoFib) Study

One-Year Clinical Outcome in Middle Eastern Patients with Atrial Fibrillation: The Jordan Atrial Fibrillation (JoFib) Study

Atrial Fibrillation Is Associated with Increased Mortality in Patients Presenting with Ventricular Tachyarrhythmias

The Diagnostic Value of Combined 24-h BP and ECG Holter Monitoring in Detection of Cardiac Arrhythmias in Patients with Arterial Hypertension

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