Hammoudeh Ayman, Khader Yousef, Tabbalat Ramzi, Badaineh Yahya, Kadri Nazih, Shawer Haneen, Al-Mousa Eyas, Ibdah Rasheed, Shawer Batool A, Alhaddad Imad A
Department of Cardiology, Istishari Hospital, 44 Kindi Street, Amman 11954, Jordan.
Department of Public Health, Jordan University of Science and Technology School of Medicine, 3030 Ramtha Street., Irbid 22110, Jordan.
Int J Vasc Med. 2022 Apr 13;2022:4240999. doi: 10.1155/2022/4240999. eCollection 2022.
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.
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.
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.
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.
近年来，心房颤动（AF）患者的中风预防和全身性栓塞（SE）预防发生了根本性变化。需要有关中东AF患者口服抗凝剂（OAC）的当代使用情况和心血管结局的数据。
约旦心房颤动（JoFib）研究纳入了2019年5月至2020年10月期间约旦连续的AF患者，并在入组后进行了一年的随访。
总体而言，共纳入2020例患者。平均年龄为67.9±13.0岁。1849例（91.5%）患者被诊断为非瓣膜性房颤（NVAF）。85.7%的高危NVAF患者（女性CHA2DS2-VASc评分>3，男性>2）使用了OAC，其中64.1%使用直接口服抗凝剂（DOAC），35.9%使用维生素K拮抗剂（VKA）。使用相同OAC药物的患者依从率为90.6%。一年心血管（CV）死亡率为7.8%，中风/SE为4.5%，大出血事件为2.6%。NVAF患者全因死亡的独立预测因素为年龄>75岁、心力衰竭、大出血事件、2型糖尿病、住院入组和冠心病。使用OAC与较低的全因死亡率相关。中风/SE的最强独立预测因素为高危CHA2DS2-VASc评分和既往中风史。
这项对中东AF患者的研究报告了对OAC的高依从性。使用OAC与较低的全因死亡风险相关。中风和大出血事件的一年发生率与世界其他地区报告的发生率相当。
