The Atrial FibriLlatiOn Registry (FLOW-AF): Patient Characteristics, Treatment Patterns, and Outcomes in Egypt

Real-world data on atrial fibrillation (AF) in the Middle East and North Africa (MENA) region, including Egypt, are sparse. The aim of the FLOW-AF registry was to evaluate the characteristics, treatment patterns, and clinical and economic outcomes of newly diagnosed non-valvular atrial fibrillation (NVAF) patients within the MENA region, including Egypt.

This multicenter, prospective, observational registry enrolled newly diagnosed patients with NVAF from January 2020 to December 2022 at eight private-sector healthcare centers in Egypt. Data were collected at enrollment (baseline), and then at 6-month and 12-month follow-up. Baseline data included demographics, AF characteristics, medical history, and antithrombotic treatment patterns. Follow-up data included clinical events, healthcare resource utilization, and related costs.

A total of 723 patients were enrolled. Overall, 51.87% were females, and the mean age was 61.9 years. All patients attended the private health sector. The mean (standard deviation) CHA₂DS₂-VASc and HAS-BLED risk scores were 2.37 (1.55) and 1.46 (1.18), respectively. Non-vitamin K antagonist oral anticoagulants (62.52%), vitamin K antagonists (22.28%), and antiplatelet therapy (9.85%) were among the prescribed treatments. Rates of transient ischemic attack and all-cause mortality were 2.64% and 0.83%, respectively; all other outcomes (stroke, bleeding, myocardial infarction, systemic embolism) occurred at a rate of ≤ 0.41%. Antithrombotic medications were the major contributors to per-patient total yearly cost (USD 381.2).

The FLOW-AF study showed that patients with NVAF in Egypt are younger and exhibit lower mean baseline CHA₂DS₂-VASc and HAS-BLED scores compared to Western and other Eastern regions. Additional research, including a broader study population with a longer follow-up, is essential to comprehensively assess the characteristics and outcomes of the NVAF population in Egypt.