Atrial Fibrillation in Africa: Clinical Characteristics, Prognosis and Adherence to Guidelines in Cameroon

Author(s): M. Ntep Gweth*1, M. Zimmermann2, A. Meiltz2, S. Kingue3, P. Ndobo1, P. Urban2, A. Bloch2
Affiliation(s): 1Service de cardiologie, Hôpital Central, Yaoundé, Cameroon, 2Département cardiovasculaire, Hôpital de La Tour, Meyrin, Switzerland, 3Service de cardiologie, Hôpital Général, Yaoundé, Cameroon
Keywords: Atrial fibrillation; Africa; prognosis; guidelines; anticoagulation
Background:

The purpose of this prospective study was to characterise the clinical profile of patients with AF in the urban population of a Sub-Saharan African country and to assess how successfully current guidelines are applied in that context.

Methods:

This prospective study involved 10 cardiologists in Cameroon. Enrolment started on 01.06.2006 and ended on 30.06.2007. Consecutive patients were included if they were >18 years and AF was documented on an ECG during the index office visit.

Results/Conclusions:

In this survey, 172 patients were enrolled (75 male; 97 female; mean age 65.8 ± 13 years). The prevalence of paroxysmal, persistent and permanent AF was 22.7%, 21.5% and 55.8%, respectively. Underlying cardiac disorders, present in 156/172 patients (90.7%), included hypertensive heart disease (47.7%), valvular heart disease (25.6%), dilated cardiomyopathy (15.7%) and coronary artery disease (6%). A rate-control strategy was chosen in 83.7% of patients (144/172) and drugs most commonly used were digoxin and amiodarone. The mean CHADS2 score was 1.9 ± 1.1 and 158/172 patients (91.9%) had a CHADS2 score ≥ 1. Among patients with an indication for oral anticoagulation (OAC), only 34.2% (54/158) actually received it. During a follow-up of 318 ± 124 days, 26/88 patients died (29.5%), essentially from a cardio-vascular cause (15/26). Eleven patients (12.5%) had a non lethal embolic stroke and 23 (26.1%) had symptoms of severe congestive heart failure.

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