CLINICAL EPIDEMIOLOGY OF ATRIAL FIBRILLATION IN NIGERIA: FINDINGS FROM THE IBADAN ATRIAL FIBRILLATION REGISTRY
Authors & Affiliations
Okechukwu Samuel Ogah. PhD1,2, 3*, Olanike Allison Orimolade. MBBS2, 3, Joshua Odunayo Akinyemi, PhD4, Chima Uzoma Akunwata, MBBS5, Chidinma Martha Ogah.MBBS3, Omokorede Oluwafikunmi Ademowo-Olusanya3,5, Akinyemi Aje. MD2, Oladimeji Muritala Adebayo,.MSc2,6, Abiodun Moshood Adeoye.MSc1,2, Adewole Adesoji Adebiyi. MBBS1,2, Olulola Olutoyin Oladapo. MSc1,2, Wuraola Adebola Shokunbi MBBS4, Mayowa Ojo Owolabi. DSc7, Ayodele Olajide Falase. MD1 Affiliation 1Cardiology Unit, Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria 2Cardiology Unit, Department of Medicine, University College Hospital, Ibadan, Oyo State, Nigeria 3Cardiomyopathies, Heart Failure and Atrial Fibrillation Research Projects, Cardiology Unit, Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria 4Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria 4Department of Haematology, University College Hospital, Ibadan, Oyo State, Nigeria 5Institute of Cardiovascular Diseases, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria 6Neurology Unit, Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria *Professor Okechukwu S Ogah Faculty of Clinical Sciences, College of Medicine, University of Ibadan, Ibadan, PMB 5116, Ibadan G.P.O, Ibadan, Oyo State, NIGERIA Oyo State, Nigeria Tel. +234 806 77 47 121
📖 Abstract Content
Background We sought to describe the clinical profile, risk factors, management, and one-year outcomes of atrial fibrillation in a tertiary hospital in Nigeria Methods The Ibadan AF registry enrolled consecutive patients with AF from January 1, 2016, to September 30, 2023, at Nigeria’s oldest and largest tertiary hospital.
Results Three hundred and fifty-seven patients were enrolled, aged 63±15 years; 52.9% were male. Hypertension was globally the most common risk factor for AF (80.7%), while rheumatic heart disease and coronary artery disease were recorded in 10.6% and 2.5%, respectively. Heart failure was the commonest mode of presentation (70%), and (14.6%). The mean CHA2DS2-VASc score was 3.1±1.4. Sixty-one percent of patients had permanent AF, 25.0% had persistent, and 14% had paroxysmal AF. The majority (78.4%) of patients were on oral anticoagulants The majority received rate control with betablockers (75%) and/ or digoxin (44%), and adequate rate control was achieved in 70%. Rhythm control pharmacologically was attempted with Amiodarone in 13.2%. Only very few had electrical cardioversion (1.1%), catheter ablation (1.1), and AV node ablation/ Pacemaker implantation (1.1)
Conclusion Hypertension is the commonest risk factor for AF in our cohort, and hypertensive heart failure is the commonest mode of presentation. More than 80% of study participants with AF require anticoagulation. Mortality at 12 months is high due to severe structural disease and high comorbidity burden. Efforts are needed in the control and treatment of risk factors, heart failure, and comorbidities in the management of AF in our setting.
