| Title | Symptom Status, Clinical Subtypes, and Prognosis in Patients With Atrial Fibrillation from the Middle East Region (from the Gulf-SAFE Registry) |
| Authors | Xie, Peng-Xin Li, Yan-Guang Alsheikh-Ali, Alawi A. AlMahmeed, Wael Shehab, Abdullah Sulaiman, Kadhim Asaad, Nidal Guo, Li-Jun Liu, Shu-Wang Zubaid, Mohammad Lip, Gregory Y. H. |
| Affiliation | Peking Univ, Dept Cardiol, Hosp 3, Beijing, Peoples R China Univ Birmingham, Inst Appl Hlth Res, Birmingham, W Midlands, England Mohammed Bin Rashid Univ Med & Hlth Sci, Coll Med, Dubai, U Arab Emirates Cleveland Clin, Heart & Vasc Inst, Abu Dhabi, U Arab Emirates UAE Univ, Coll Med & Hlth Sci CMHS, Internal Med Dept, Al Ain, U Arab Emirates Royal Hosp, Dept Cardiol, Muscat, Oman Hamad Med Corp, Cardiol Dept, Heart Hosp, Doha, Qatar Kuwait Univ, Fac Med, Dept Med, Kuwait, Kuwait Univ Liverpool, Liverpool Ctr Cardiovasc Sci, Liverpool, Merseyside, England Liverpool Heart & Chest Hosp, Liverpool, Merseyside, England |
| Keywords | MANAGEMENT OUTCOMES RISK PRESENTATIONS ASSOCIATION GUIDELINES |
| Issue Date | 15-Apr-2022 |
| Publisher | AMERICAN JOURNAL OF CARDIOLOGY |
| Abstract | Atrial fibrillation (AF) is often asymptomatic. The prognosis of asymptomatic AF is at least similar or worse than symptomatic AF, but there are no such data from Middle East patients with AF. The Gulf-SAFE (Gulf Survey of Atrial Fibrillation Events) registry is a multicenter prospective survey of patients presenting with AF to participate medical institutions in 6 countries in the Gulf region. We investigated the prognostic outcomes of patients with asymptomatic AF in relation to clinical subtypes. A total of 2043 patients with AF were included; 541 were identified as having asymptomatic AF (26.5%) who tended to be older, with higher prevalences of hypertension, heart failure, coronary artery disease, diabetes, stroke, renal dysfunction, chronic obstructive pulmonary disease, and had higher Congestive heart failure, Hypertension, Age >= 75, Stroke (2 points), Congestive heart failure, Hypertension, Age >= 75 (2 points), Diabetes, Stroke (2 points), Vascular disease, Age 65-74, Sex category (CHA2DS2-VASc), and Hypertension, Age >= 65, Stroke, Bleeding history, liable INR, Elderly, Drug or alcohol use (HAS-BLED) scores (all p <0.05). After multivariable adjustment, asymptomatic AF was associated with higher risks of stroke/systematic embolism (SE) (adjusted odds ratio [aOR] 2.18, 95% confidence interval [CI] 1.10 to 4.34), all-cause mortality (aOR 2.85, 95% CI 1.90 to 4.28), and the composite outcome of stroke/SE, bleeding, and all-cause mortality (aOR 1.74, 95% CI 1.26 to 2.41). Patients with asymptomatic AF had fewer admissions for AF (aOR 0.53, 95% CI 0.32 to 0.83) and heart failure (aOR 0.58, 95% CI 0.38 to 0.86). The increased risk of stroke/SE in asymptomatic AF was more prominent among paroxysmal AF subtype (p for interaction = 0.028). In conclusion, in the Gulf-SAFE registry, patients with asymptomatic AF represent a nonbenign entity with worse outcomes compared with symptomatic AF. In paroxysmal AF, the higher risks of events were more prominent. The absence of "warning signs" and lack of timely admission in asymptomatic AF may be major reasons for the unfavorable prognosis. (C) 2021 Elsevier Inc. All rights reserved. |
| URI | http://hdl.handle.net/20.500.11897/649992 |
| ISSN | 0002-9149 |
| DOI | 10.1016/j.amjcard.2021.12.060 |
| Indexed | SCI(E) |
| Appears in Collections: | 第三医院 |
