Clinical characteristics and outcomes of atrial fibrillation and flutter at the Aga Khan University Hospital, Nairobi : cardiovascular topics
| Autor: | Harun Otieno, Ashna Jinah, Gerald Yonga, Abednego Moriasi, Sitna Mwanzi, J. Shavadia |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
medicine.medical_specialty
Digoxin business.industry Retrospective cohort study Atrial fibrillation General Medicine medicine.disease Comorbidity Heart failure Internal medicine Epidemiology medicine Cardiology Palpitations medicine.symptom Cardiology and Cardiovascular Medicine business Atrial flutter medicine.drug |
| Zdroj: | Cardiovascular Journal Of Africa. 24:6-9 |
| ISSN: | 1680-0745 1995-1892 |
| DOI: | 10.5830/cvja-2012-064 |
| Popis: | Introduction : Scant data exist on the epidemiology and clinical characteristics of atrial fibrillation in Kenya. Traditionally, atrial fibrillation (AF) in sub-Saharan Africa is as a result of rheumatic valve disease. However, with the economic transition in sub-Saharan Africa, risk factors and associated complications of this arrhythmia are likely to change. Methods : A retrospective observational survey was carried out between January 2008 and December 2010. Patients with a discharge diagnosis of either atrial fibrillation or flutter were included for analysis. The data-collection tool included clinical presentation, risk factors and management strategy. Follow-up data were obtained from the patients' medical records six months after the index presentation. Results : One hundred and sixty-two patients were recruited (mean age 67 ± 17 years, males 56%). The distribution was paroxysmal (40%), persistent (20%) and permanent AF (40%). Associated co-morbidities included hypertension (68%), heart failure (38%) diabetes mellitus (33%) and valvular abnormalities (12%). One-third presented with palpitations, dizziness or syncope and 15% with a thromboembolic complication as the index AF presentation. Rate-control strategies were administered to 78% of the patients, with beta-blockers and digoxin more commonly prescribed. Seventy-seven per cent had a CHA2DS2VASC score ≥ 2, but one-quarter did not receive any form of oral anticoagulation. At the six-month follow up, 6% had died and 12% had been re-admitted at least once. Of the high-stroke risk patients on anticoagulation, just over one-half were adequately anticoagulated. Conclusion : Hypertension and diabetes mellitus, not rheumatic valve disease were the more common co-morbidities. Stroke risk stratification and prevention needs to be emphasised and appropriately managed. |
| Databáze: | OpenAIRE |
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