Demographics and Risk Profile of Elderly Middle Eastern Patients with Atrial Fibrillation: The Jordan Atrial Fibrillation (JoFib) Study.

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Citation: Vascular Health & Risk Management. 18:289-295, 2022.PMID: 35449533Institution: MedStar Union Memorial HospitalDepartment: Internal Medicine ResidencyForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Atrial Fibrillation | *Stroke | Aged | Aged | Aged, 80 and over | Anticoagulants/ae [Adverse Effects] | Atrial Fibrillation/di [Diagnosis] | Atrial Fibrillation/dt [Drug Therapy] | Atrial Fibrillation/ep [Epidemiology] | Female | Humans | Jordan/ep [Epidemiology] | Male | Prevalence | Risk Factors | Stroke/di [Diagnosis] | Stroke/ep [Epidemiology] | Stroke/pc [Prevention & Control]Year: 2022ISSN:
  • 1176-6344
Name of journal: Vascular health and risk managementAbstract: Background: Atrial fibrillation (AF) is the most common arrhythmia that is associated with high morbidity and mortality. The prevalence of AF increases with age and the elderly constitute a vulnerable cohort for higher stroke and bleeding complications.Clinical Studies Registration: The study is registered on clinicaltrials.gov (unique identifier number NCT03917992). Copyright ♭ 2022 Alhaddad et al.Conclusion: Elderly Middle Eastern AF patients have worse baseline clinical profiles and higher risk scores compared to younger patients. The majority of the elderly were prescribed guideline directed OACs, with higher use of DOACs than the younger cohort.Methods: A total of 2163 adult consecutive patients with AF in 19 hospitals and 11 outpatient clinics in Jordan were enrolled in the Jordan AF study from May 2019 to January 2021. The clinical characteristics, demographics, and risk profiles of the elderly patients (>=80 years old) were compared to the younger patients (<80 years old).Results: Of 2163 patients, 379 (17.5%) constituted the elderly group. The elderly group had higher prevalence of hypertension (79.9% vs 73.5%, p=0.01), lower prevalence of smoking (5.0% vs 15.2%, p<0.001) and lower body mass index (28.1 +/- 5.5 kg/m2 vs 29.8 +/- 6.2 kg/m2, p<0.001) compared with younger patients. They also had more strokes or systemic emboli (25.6% vs 14.7%, p<0.001), heart failure (30.3% vs 22.9%, p=0.002), pulmonary hypertension (30.6% vs 24.8%, p=0.02), and chronic kidney disease (13.5% vs 8.3%, p=0.002). The elderly cohort had higher mean CHA2DS2-VASc (5.0 +/- 1.5 vs 3.6 +/- 1.8, p<0.001) and HAS-BLED scores (2.2 +/- 1.1 vs 1.5 +/- 1.1, p<0.001) compared to younger group. Among 370 elderly with non-valvular AF (NVAF), oral anticoagulant agents (OACs) were prescribed for 278 (84.2%) of eligible high-risk patients. Of the 1402 younger patients with NVAF, OACs were prescribed for 1133 (84.3%) of eligible patients. Direct oral anticoagulant agents (DOACs) were more frequently used in the elderly compared to the young (72.3% vs 62.3%, p<0.001).All authors: Alhaddad IA, Alhaddad Z, Hammoudeh A, Khader YOriginally published: Vascular Health & Risk Management. 18:289-295, 2022.Fiscal year: FY2022Digital Object Identifier: Date added to catalog: 2022-05-11
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Journal Article MedStar Authors Catalog Article 35449533 Available 35449533

Background: Atrial fibrillation (AF) is the most common arrhythmia that is associated with high morbidity and mortality. The prevalence of AF increases with age and the elderly constitute a vulnerable cohort for higher stroke and bleeding complications.

Clinical Studies Registration: The study is registered on clinicaltrials.gov (unique identifier number NCT03917992). Copyright ♭ 2022 Alhaddad et al.

Conclusion: Elderly Middle Eastern AF patients have worse baseline clinical profiles and higher risk scores compared to younger patients. The majority of the elderly were prescribed guideline directed OACs, with higher use of DOACs than the younger cohort.

Methods: A total of 2163 adult consecutive patients with AF in 19 hospitals and 11 outpatient clinics in Jordan were enrolled in the Jordan AF study from May 2019 to January 2021. The clinical characteristics, demographics, and risk profiles of the elderly patients (>=80 years old) were compared to the younger patients (<80 years old).

Results: Of 2163 patients, 379 (17.5%) constituted the elderly group. The elderly group had higher prevalence of hypertension (79.9% vs 73.5%, p=0.01), lower prevalence of smoking (5.0% vs 15.2%, p<0.001) and lower body mass index (28.1 +/- 5.5 kg/m2 vs 29.8 +/- 6.2 kg/m2, p<0.001) compared with younger patients. They also had more strokes or systemic emboli (25.6% vs 14.7%, p<0.001), heart failure (30.3% vs 22.9%, p=0.002), pulmonary hypertension (30.6% vs 24.8%, p=0.02), and chronic kidney disease (13.5% vs 8.3%, p=0.002). The elderly cohort had higher mean CHA2DS2-VASc (5.0 +/- 1.5 vs 3.6 +/- 1.8, p<0.001) and HAS-BLED scores (2.2 +/- 1.1 vs 1.5 +/- 1.1, p<0.001) compared to younger group. Among 370 elderly with non-valvular AF (NVAF), oral anticoagulant agents (OACs) were prescribed for 278 (84.2%) of eligible high-risk patients. Of the 1402 younger patients with NVAF, OACs were prescribed for 1133 (84.3%) of eligible patients. Direct oral anticoagulant agents (DOACs) were more frequently used in the elderly compared to the young (72.3% vs 62.3%, p<0.001).

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