Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Clinical Profiles and One-Year Outcome in Middle Eastern Pa-Tients With Atrial Fibrillation and Major Bleeding Events

Rashid Ibdah
* ORCID logo ,
Sukaina Ismael Rawashdeh
,
Ayman Hammoudeh
,
Yahya Badaineh
,
Yousef Khader
ORCID logo ,
Ramzi Tabbalat
,
Mustafa Jammal
,
Sadan Aburumman
,
Ahmad Sadam Shannaq
,
Imad A. Alhaddad
Version 1 : Received: 4 March 2023 / Approved: 13 March 2023 / Online: 13 March 2023 (02:06:57 CET)

How to cite: Ibdah, R.; Rawashdeh, S.I.; Hammoudeh, A.; Badaineh, Y.; Khader, Y.; Tabbalat, R.; Jammal, M.; Aburumman, S.; Shannaq, A.S.; Alhaddad, I.A. Clinical Profiles and One-Year Outcome in Middle Eastern Pa-Tients With Atrial Fibrillation and Major Bleeding Events. Preprints 2023, 2023030202. https://doi.org/10.20944/preprints202303.0202.v1 Ibdah, R.; Rawashdeh, S.I.; Hammoudeh, A.; Badaineh, Y.; Khader, Y.; Tabbalat, R.; Jammal, M.; Aburumman, S.; Shannaq, A.S.; Alhaddad, I.A. Clinical Profiles and One-Year Outcome in Middle Eastern Pa-Tients With Atrial Fibrillation and Major Bleeding Events. Preprints 2023, 2023030202. https://doi.org/10.20944/preprints202303.0202.v1

Abstract

Background. Oral anticoagulants (OACs) reduce stroke and systemic embolism (SE) in patients with atrial fibrillation (AF) but increase the risk of major bleeding (MB). No study has addressed the incidence and outcomes of bleeding in AF patients in the Middle East (ME). The Jordan AF study evaluated clinical profiles and one-year outcomes of AF patients who sustained bleeding events. Methods. Patients in 29 hospitals and clinics (May 2019 - December 2020) were enrolled and followed up for one year. Demographics and one-year events were compared in patients with or without bleeding. Results. Of 2018 patients enrolled; 166 patients sustained MB or clinically relevant non-major (CRNM) bleeding (8.2 events per 100 patient-years), including 47 patients who had MB (2.3 events per 100 patient-years). Compared with 1852 (91.8%) patients who did not have bleeding, patients with MB were older and had a higher prevalence of hypertension, diabetes mellitus (DM), heart failure, and malignancy, More patients with MB than those with no bleeding were using OACs (93.6% vs. 78.9%, p=0.02). Patients with MB had significantly higher one-year rates of stroke/SE (23.4% vs. 3.6%, p<0.0001) and all-cause mortality (31.9% vs 11.6%, p=0.001). Independent predictors of MB were stroke/SE (OR 10.8, 95% CI 5.3-21.9, p<0.0001), malignancy (3.4, 1.3-8.5, p=0.01), use of OACs (4.4, 1.3-14.7, p=0.02) and DM (1.9, 1.0-3.5, p=0.04). Conclusions. MB and CRNM bleeding occurred in (≈8%) of patients with AF at one year. Patients with MB (≈2%) had worse baseline clinical profiles and one-year prognosis compared with those who did not have bleeding. Keywords: Atrial fibrillation; Major bleeding events; Clinically-relevant non-major bleeding; Oral anticoagulants; Middle Eastern population; Prognosis. Clinical studies registration: the study is registered on clinicaltrials.gov (unique identifier number NCT03917992).

Keywords

Atrial fibrillation; Major bleeding events; Clinically-relevant non-major bleeding; Oral anticoagulants; Middle Eastern population; Prognosis

Subject

Medicine and Pharmacology, Cardiac and Cardiovascular Systems

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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