Adherence to the 2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline on the Use of Oral Anticoagulant Agents in Middle Eastern Patients with Atrial Fibrillation: The Jordan Atrial Fibrillation (JoFib) Study

Background. There is a scarcity of studies that evaluate adherence to the utilization of guideline-recommended oral anticoagulant agents (OACs) in patients with atrial fibrillation (AF) in the Middle East. The Jordan Atrial Fibrillation (JoFib) Study evaluated baseline clinical profiles and the util...

Full description

Saved in:
Bibliographic Details
Main Authors: Ayman J. Hammoudeh, Yousef Khader, Nazih Kadri, Eyas Al-Mousa, Yahya Badaineh, Laith Habahbeh, Ramzi Tabbalat, Hesham Janabi, Imad A. Alhaddad
Format: Article
Language:English
Published: Wiley 2021-01-01
Series:International Journal of Vascular Medicine
Online Access:http://dx.doi.org/10.1155/2021/5515089
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849307419888320512
author Ayman J. Hammoudeh
Yousef Khader
Nazih Kadri
Eyas Al-Mousa
Yahya Badaineh
Laith Habahbeh
Ramzi Tabbalat
Hesham Janabi
Imad A. Alhaddad
author_facet Ayman J. Hammoudeh
Yousef Khader
Nazih Kadri
Eyas Al-Mousa
Yahya Badaineh
Laith Habahbeh
Ramzi Tabbalat
Hesham Janabi
Imad A. Alhaddad
author_sort Ayman J. Hammoudeh
collection DOAJ
description Background. There is a scarcity of studies that evaluate adherence to the utilization of guideline-recommended oral anticoagulant agents (OACs) in patients with atrial fibrillation (AF) in the Middle East. The Jordan Atrial Fibrillation (JoFib) Study evaluated baseline clinical profiles and the utilization of OACs, including vitamin K antagonists (VKAs) and direct OACs (DOACs), in patients with valvular AF (VAF) and nonvalvular AF (NVAF) according to the 2019 focused update of the 2014 AHA/ACC/HRS guidelines. Methods. Consecutive patients with AF were enrolled in 29 hospitals and outpatient clinics. The use of OACs was evaluated in patients with VAF and NVAF according to the prespecified guideline. Results. Of 2000 patients, 177 (8.9%) had VAF and 1823 (91.1%) had NVAF. A VKA was prescribed for 88.1% of the VAF group. In the NVAF group, 1468 (80.5%) of patients had a high CHA2DS2-VASc score, i.e., a score of ≥3 in women and ≥2 in men; 202 (11.1%) patients had an intermediate CHA2DS2-VASc score, i.e., a score of 2 in women and 1 in men; and 153 (8.4%) patients had a low CHA2DS2-VASc score, i.e., a score of 1 in women and 0 in men. Of patients with a high CHA2DS2-VASc score, 1204 (82.0%) received OACs, including DOACs for 784 (53.4%) and VKA for 420 (28.6%) patients. Among patients with an intermediate score, OACs were prescribed for 148 (73.3%) patients, including 107 (53.0%) who received DOACs and 41 (20.3%) patients who received VKA. In patients with a low score, OACs were omitted in 94 (61.4%) patients and prescribed for 59 (38.6%) patients. Multivariate analysis showed that age between 50 and 70 years, CHA2DS2-VASc score of ≥2, a diagnosis of stroke or systemic embolization, and nonparoxysmal AF were significantly associated with increased odds of OAC prescription. Conclusions. The current status of the utilization of OACs in Middle Eastern AF patients appears to be promising and is consistent with the 2019 focused update of the 2014 AHA/ACC/HRS guideline. This trial is registered with NCT03917992.
format Article
id doaj-art-209e812533e94540b764581979249f8a
institution Kabale University
issn 2090-2824
2090-2832
language English
publishDate 2021-01-01
publisher Wiley
record_format Article
series International Journal of Vascular Medicine
spelling doaj-art-209e812533e94540b764581979249f8a2025-08-20T03:54:47ZengWileyInternational Journal of Vascular Medicine2090-28242090-28322021-01-01202110.1155/2021/55150895515089Adherence to the 2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline on the Use of Oral Anticoagulant Agents in Middle Eastern Patients with Atrial Fibrillation: The Jordan Atrial Fibrillation (JoFib) StudyAyman J. Hammoudeh0Yousef Khader1Nazih Kadri2Eyas Al-Mousa3Yahya Badaineh4Laith Habahbeh5Ramzi Tabbalat6Hesham Janabi7Imad A. Alhaddad8Cardiology Department, Istishari Hospital, 44 Kindi Street Amman 11184, JordanDepartment of Public Health, Jordan University of Science and Technology School of Medicine, 3030 Ramtha Street, P.O. Box 3030, Irbid 22110, JordanElectrophysiology and General Cardiology Sections, Cardiology Department, Abdali Hospital, 1 Al-Istethmar Street, Abdali Boulevard, Amman 11190, JordanCardiology Department, Istishari Hospital, 44 Kindi Street Amman 11184, JordanCardiology Department, Istishari Hospital, 44 Kindi Street Amman 11184, JordanCardiology Department, Istishari Hospital, 44 Kindi Street Amman 11184, JordanElectrophysiology and General Cardiology Sections, Cardiology Department, Abdali Hospital, 1 Al-Istethmar Street, Abdali Boulevard, Amman 11190, JordanIntensive Care Unit, Istishari Hospital, 44 Kindi Street, Amman 11184, JordanCardiology Department, Aqaba Isl Hospital, 15 Sharif Shaker Ben Zaidstreet, Aqaba 77110, JordanBackground. There is a scarcity of studies that evaluate adherence to the utilization of guideline-recommended oral anticoagulant agents (OACs) in patients with atrial fibrillation (AF) in the Middle East. The Jordan Atrial Fibrillation (JoFib) Study evaluated baseline clinical profiles and the utilization of OACs, including vitamin K antagonists (VKAs) and direct OACs (DOACs), in patients with valvular AF (VAF) and nonvalvular AF (NVAF) according to the 2019 focused update of the 2014 AHA/ACC/HRS guidelines. Methods. Consecutive patients with AF were enrolled in 29 hospitals and outpatient clinics. The use of OACs was evaluated in patients with VAF and NVAF according to the prespecified guideline. Results. Of 2000 patients, 177 (8.9%) had VAF and 1823 (91.1%) had NVAF. A VKA was prescribed for 88.1% of the VAF group. In the NVAF group, 1468 (80.5%) of patients had a high CHA2DS2-VASc score, i.e., a score of ≥3 in women and ≥2 in men; 202 (11.1%) patients had an intermediate CHA2DS2-VASc score, i.e., a score of 2 in women and 1 in men; and 153 (8.4%) patients had a low CHA2DS2-VASc score, i.e., a score of 1 in women and 0 in men. Of patients with a high CHA2DS2-VASc score, 1204 (82.0%) received OACs, including DOACs for 784 (53.4%) and VKA for 420 (28.6%) patients. Among patients with an intermediate score, OACs were prescribed for 148 (73.3%) patients, including 107 (53.0%) who received DOACs and 41 (20.3%) patients who received VKA. In patients with a low score, OACs were omitted in 94 (61.4%) patients and prescribed for 59 (38.6%) patients. Multivariate analysis showed that age between 50 and 70 years, CHA2DS2-VASc score of ≥2, a diagnosis of stroke or systemic embolization, and nonparoxysmal AF were significantly associated with increased odds of OAC prescription. Conclusions. The current status of the utilization of OACs in Middle Eastern AF patients appears to be promising and is consistent with the 2019 focused update of the 2014 AHA/ACC/HRS guideline. This trial is registered with NCT03917992.http://dx.doi.org/10.1155/2021/5515089
spellingShingle Ayman J. Hammoudeh
Yousef Khader
Nazih Kadri
Eyas Al-Mousa
Yahya Badaineh
Laith Habahbeh
Ramzi Tabbalat
Hesham Janabi
Imad A. Alhaddad
Adherence to the 2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline on the Use of Oral Anticoagulant Agents in Middle Eastern Patients with Atrial Fibrillation: The Jordan Atrial Fibrillation (JoFib) Study
International Journal of Vascular Medicine
title Adherence to the 2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline on the Use of Oral Anticoagulant Agents in Middle Eastern Patients with Atrial Fibrillation: The Jordan Atrial Fibrillation (JoFib) Study
title_full Adherence to the 2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline on the Use of Oral Anticoagulant Agents in Middle Eastern Patients with Atrial Fibrillation: The Jordan Atrial Fibrillation (JoFib) Study
title_fullStr Adherence to the 2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline on the Use of Oral Anticoagulant Agents in Middle Eastern Patients with Atrial Fibrillation: The Jordan Atrial Fibrillation (JoFib) Study
title_full_unstemmed Adherence to the 2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline on the Use of Oral Anticoagulant Agents in Middle Eastern Patients with Atrial Fibrillation: The Jordan Atrial Fibrillation (JoFib) Study
title_short Adherence to the 2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline on the Use of Oral Anticoagulant Agents in Middle Eastern Patients with Atrial Fibrillation: The Jordan Atrial Fibrillation (JoFib) Study
title_sort adherence to the 2019 aha acc hrs focused update of the 2014 aha acc hrs guideline on the use of oral anticoagulant agents in middle eastern patients with atrial fibrillation the jordan atrial fibrillation jofib study
url http://dx.doi.org/10.1155/2021/5515089
work_keys_str_mv AT aymanjhammoudeh adherencetothe2019ahaacchrsfocusedupdateofthe2014ahaacchrsguidelineontheuseoforalanticoagulantagentsinmiddleeasternpatientswithatrialfibrillationthejordanatrialfibrillationjofibstudy
AT yousefkhader adherencetothe2019ahaacchrsfocusedupdateofthe2014ahaacchrsguidelineontheuseoforalanticoagulantagentsinmiddleeasternpatientswithatrialfibrillationthejordanatrialfibrillationjofibstudy
AT nazihkadri adherencetothe2019ahaacchrsfocusedupdateofthe2014ahaacchrsguidelineontheuseoforalanticoagulantagentsinmiddleeasternpatientswithatrialfibrillationthejordanatrialfibrillationjofibstudy
AT eyasalmousa adherencetothe2019ahaacchrsfocusedupdateofthe2014ahaacchrsguidelineontheuseoforalanticoagulantagentsinmiddleeasternpatientswithatrialfibrillationthejordanatrialfibrillationjofibstudy
AT yahyabadaineh adherencetothe2019ahaacchrsfocusedupdateofthe2014ahaacchrsguidelineontheuseoforalanticoagulantagentsinmiddleeasternpatientswithatrialfibrillationthejordanatrialfibrillationjofibstudy
AT laithhabahbeh adherencetothe2019ahaacchrsfocusedupdateofthe2014ahaacchrsguidelineontheuseoforalanticoagulantagentsinmiddleeasternpatientswithatrialfibrillationthejordanatrialfibrillationjofibstudy
AT ramzitabbalat adherencetothe2019ahaacchrsfocusedupdateofthe2014ahaacchrsguidelineontheuseoforalanticoagulantagentsinmiddleeasternpatientswithatrialfibrillationthejordanatrialfibrillationjofibstudy
AT heshamjanabi adherencetothe2019ahaacchrsfocusedupdateofthe2014ahaacchrsguidelineontheuseoforalanticoagulantagentsinmiddleeasternpatientswithatrialfibrillationthejordanatrialfibrillationjofibstudy
AT imadaalhaddad adherencetothe2019ahaacchrsfocusedupdateofthe2014ahaacchrsguidelineontheuseoforalanticoagulantagentsinmiddleeasternpatientswithatrialfibrillationthejordanatrialfibrillationjofibstudy