Key result
In Middle Eastern patients with atrial fibrillation, coexisting coronary artery disease was associated with significantly higher one-year all-cause mortality (18.5% vs. 10.9%) and hospitalization rates (39.4% vs. 29.2%) compared to those without coronary artery disease.
Why the study?
Clinical studies evaluating the association of AF and CAD in the Middle East are scarce, leaving the impact of CAD on baseline profiles and outcomes uncertain.
Does the presence of concomitant coronary artery disease worsen one-year clinical outcomes in Middle Eastern patients with atrial fibrillation?
Observational (n=2,020)
Yes
Does the presence of concomitant coronary artery disease worsen one-year clinical outcomes in Middle Eastern patients with atrial fibrillation?
Absolute Event Rate: 18.5% vs 10.9%
p-value: p=0.002
AF/CAD coexistence was associated with higher one-year mortality and hospitalizations; leaves open whether integrated management improves outcomes in Middle Eastern cohorts.
Background: There is a scarcity of clinical studies which evaluate the association of atrial fibrillation (AF) and coronary artery disease (CAD) in the Middle East. The aim of this study was to evaluate the impact of CAD on baseline clinical profiles and one-year outcomes in a Middle Eastern cohort with AF. Methods: Consecutive AF patients evaluated in 29 hospitals and cardiology clinics were enrolled in the Jordan AF Study (May 2019-December 2020). Clinical and echocardiographic features, use of medications and one-year outcomes in patients with AF/CAD were compared to AF/no CAD patients. Results: VASc and HAS-BLED scores were higher in AF/CAD patients than those with AF/no CAD (4.3 ± 1.7 vs. 3.6 ± 1.8, p < 0.0001) and (2.0 ± 1.1 vs. 1.6 ± 1.1, p < 0.0001), respectively. Oral anticoagulant agents were used in similar rates in the two groups (83.8% vs. 82.9%, p = 0.81), but more patients with AF/CAD were prescribed additional antiplatelet agents compared to patients with AF/no CAD (73.7% vs. 41.5%, p < 0.0001). At one year, AF/CAD patients, compared to AF/no CAD patients had significantly higher hospitalization rate (39.4% vs. 29.2%, p = 0.003), more acute coronary syndrome and coronary revascularization (6.9% vs. 2.4%, p = 0.004), and higher all-cause mortality (18.5% vs. 10.9%, p = 0.002). Conclusions: In this cohort of Middle Eastern patients with AF, one in 10 patients had CAD. The coexistence of AF and CAD was associated with a worse baseline clinical profile and one-year outcomes. Clinical study registration: the study is registered on clinicaltrials.gov (unique identifier number NCT03917992).
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Hammoudeh et al. (2024) conducted an observational in Atrial fibrillation (n=2,020). Coronary artery disease vs. No coronary artery disease was evaluated on All-cause mortality (p=0.002). In Middle Eastern patients with atrial fibrillation, coexisting coronary artery disease was associated with significantly higher one-year all-cause mortality (18.5% vs. 10.9%) and hospitalization rates (39.4% vs. 29.2%) compared to those without coronary artery disease.
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