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Published on: February 26, 2013
The Atrial FibriLlatiOn (FLOW-AF) Registry in the Middle East and North Africa: Patient Characteristics, Treatment
Wael A Almahmeed1, Ahmad Hersi2, Natasha Khalife3
1Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates. wmahmeed@gmail.com.
Insights
The FLOW-AF registry found that newly diagnosed non-valvular atrial fibrillation (NVAF) patients in the Middle East and North Africa (MENA) region were younger with lower risk scores and experienced low clinical event rates over one year.
Area of Science:
- Cardiology
- Epidemiology
- Public Health
Background:
- Limited data exist on atrial fibrillation (AF) prevalence and outcomes in the Middle East and North Africa (MENA) region.
- The FLOW-AF registry was established to address this gap, focusing on newly diagnosed non-valvular atrial fibrillation (NVAF).
Purpose of the Study:
- To evaluate the demographic and clinical characteristics of NVAF patients in the MENA region.
- To assess current treatment patterns, including anti-thrombotic therapy, for NVAF in this population.
- To determine the clinical and economic outcomes of NVAF patients over a 12-month follow-up period.
Main Methods:
- A multi-center, prospective, observational study (FLOW-AF registry) was conducted across Egypt, Lebanon, Saudi Arabia, and the UAE.
- 1418 patients with newly diagnosed NVAF were enrolled, with data collected at baseline and at 6- and 12-month follow-ups.
- Data included demographics, AF characteristics, medical history, anti-thrombotic treatment, clinical events, and healthcare resource utilization.
Main Results:
- The study enrolled 1418 patients, with a mean age of 64.5 years. The mean CHA 2 DS 2 -VASc and HAS-BLED scores were 2.7 and 1.6, respectively.
- Non-vitamin K antagonist oral anticoagulants (NOACs) were prescribed to 65.8% of patients, followed by antiplatelet therapy (16.4%) and vitamin K antagonists (VKAs) (12.9%).
- Observed 1-year clinical event rates included bleeding (1.7%), transient ischemic attack (1.7%), all-cause mortality (1.7%), stroke (0.6%), myocardial infarction (0.2%), and systemic embolism (0.08%).
Conclusions:
- The MENA NVAF patient population in this registry was characterized by younger age and lower mean baseline CHA 2 DS 2 -VASc and HAS-BLED scores compared to other regions.
- The observed rates of major clinical outcomes over one year were low in this cohort.
- Longer follow-up periods are necessary to fully ascertain the long-term clinical outcomes in this specific patient population.
Introduction:
Limited data on atrial fibrillation (AF) are available from the Middle East and North Africa region (MENA). The aim of the FLOW-AF registry was to evaluate the characteristics, treatment patterns, and clinical and economic outcomes of patients with newly diagnosed non-valvular atrial fibrillation (NVAF) in MENA.
Methods:
This multi-center, prospective, observational study (the FLOW-AF registry) enrolled patients newly diagnosed with NVAF across Egypt, Lebanon, Kingdom of Saudi Arabia, and United Arab Emirates. The data collection occurred at enrollment (baseline) and after 6- and 12-months (follow-up). Baseline data included demographics, AF characteristics, medical history, and anti-thrombotic treatment patterns. Clinical events, healthcare resource utilization, and direct costs were collected at follow-up.
Results:
The study enrolled a total of 1418 patients (52.7% males and 47.3% females). The mean age of the patients was 64.5 years and 90.6% were white. The mean (standard deviation) CHA2DS2-VASc and HAS-BLED risk scores were 2.7 (1.6) and 1.6 (1.2), respectively. Non-vitamin K antagonist oral anticoagulants, antiplatelet therapy, and vitamin K antagonists were prescribed to 65.8%, 16.4%, and 12.9% patients, respectively. During follow-up, the following rates of clinical outcomes were observed: bleeding events (1.7%), transient ischemic attack (1.7%), all-cause mortality (1.7%), stroke (0.6%), myocardial infarction (0.2%), and systemic embolism (0.08%).
Conclusions:
This MENA patient population was younger and had lower mean baseline CHA2DS2-VASc and HAS-BLED scores. The rates of clinical outcomes over 1-year in this study were low. Longer follow-up is required to comprehensively assess clinical outcomes in this patient population.
