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Abstract
RÉSUMÉ
Introduction. La fibrillation atriale et l’insuffisance cardiaque sont des pathologies souvent associées, aggravant le pronostic vital et représentent un problème de santé publique. L’objectif de ce travail était d’évaluer la prévalence de la fibrillation atriale chez les patients en insuffisance cardiaque chronique et déterminer le profil clinique de ce groupe de patients. Matériels et méthodes. Nous avons mené une étude transversale descriptive réalisée à la polyclinique Guindo de Bamako de Novembre 2017 à Octobre 2018 incluant les patients âgés de plus de 18 ans ayant une insuffisance cardiaque chronique avec une fibrillation atriale. Résultats. L’étude a concerné 15 malades sur 108 malades vus en consultation ou hospitalisé, soit une prévalence hospitalière de 13,9%.La fréquence des facteurs de risque cardiovasculaires associés à la fibrillation atrilale était de 53,3% pour la sédentarité,46,7% pour l'hypertension artérielle, 33,3% pour le tabac, 20% pour le diabète, et 13,3% pour la dyslipidémie. Les étiologies de l'insuffisance cardiaque chronique associées à la fibrillation atriale ont été : les valvulopathies (40%); hypertensives (26,7%);les coronaropathies (13,3%), cœur pulmonaire chronique (13,3%) et primitive (6,7%). Les antivitamines K (AVK) étaient les antithrombotiques plus prescrits avec 53,3%, suivi des anticoagulants oraux directs (AOD) avec 33,3% des cas. La digoxine et les bêtabloquants étaient les antiarythmiques les plus prescrits avec respectivement 40% et 33,3%. Conclusion. La fibrillation atriale reste fréquente dans la population des patients insuffisants cardiaques à la polyclinique Guindo de Bamako et la moyenne d’âge est inférieure à celle retrouvée dans la littérature.
ABSTRACT
Introduction. Atrial fibrillation and heart failure are often associated pathologies, worsening the prognosis and represent a public health problem. The objective of ours study was to assess the prevalence of atrial fibrillation in patients with chronic heart failure and to determine the clinical profile of this group of patients. Materials and methods. We conducted a transversal descriptive study based on the hospitalization and cardiology consultation records of the polyclinic Guindo of Bamako from November 2017 to October 2018. We included patients over 18 years of age with chronic heart failure with atrial fibrillation. Results. During this period, fifteen (15) patients with chronic heart failure with atrial fibrillation (AF) were included in a total of 108 patients with heart failure. The prevalence of atrial fibrillation was 13.9%. The frequency of cardiovascular risk factors associated with FA was (53.3%) for physical inactivity, (46.7%) for arterial hypertension, (33.3%) for tobacco, (20%) for diabetes, and (13, 3%) for dyslipidemia. Etiologies of chronic heart failure associated with atrial fibrillation were: valvulopathies (40%); Hypertensives (26.7%), coronary artery disease (13.3%); chronic pulmonary heart(13.3%) and primary (6.7%).Vitamin K antagonist (VKA) were the most prescribed antithrombotics with 53.3%, followed by oral direct anticoagulants (DOACs) with 33.3% of cases. Digoxin and beta blockers were the most prescribed antiarrhythmics with 40% and 33.3% respectively.Conclusion: Atrial fibrillation remains frequent in the population of heart failure patients at the Guindo polyclinic of Bamako and the average age is lower than that found in the literature.
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References
- Ragbaoui Y, Chehbouni C, El Hammiri A, Epidémiologie de l’association fibrillation atriale et insuffisance cardiaque.Pan Afr Med J. 2017; 26: 116.
- Deedwania PC, Lardizabal JA. Atrial fibrillation in heart failure: a comprehensive review. Am J Med. 2010 Mar;123(3):198–204.
- Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Blaha MJ, et al. Heart disease and stroke statistics--2014 update: a report from the American Heart Association. Circulation. 2014 Jan 21;129(3):e28–e29. Epub 2013/12/20. Eng.
- -M.Thiam.Insuffisance cardiaque en milieu cardiologique afircain.Bull Soc Pathol.Exot, 2003,96,217-8
- -M. Pio,E.Goeh-Akue,Y.Afassinou,B.Atta,E.Missihoun,K.Ehlan.Insuffisance cardiaque du sujet jeune: aspects épidémiologiques,cliniques et étiologiques au CHU Sylvanus Olympio de Lomé.Annales de Cardiologie et d’Angéiologie. 2014 Sept.63(4) ;240-44.
- Stevenson WG, Stevenson LW. Atrial fibrillation in heart failure. N Engl J Med. 1999 Sep 16; 341(12):910–1.
- Cerit L. The Paradox of Heart Failure and Atrial Fibrillation. Journal of the American College of Cardiology. 2016 Sep 13; 68(11):1252–3g.
- Maisel WH, Stevenson LW. Atrial fibrillation in heart failure: epidemiology, pathophysiology, and rationale for therapy. Am J Cardiol. 2003 Mar 20; 91(6a):2d–8d.
- Cleland JG, Swedberg K, Follath F, Komajda M, Cohen-Solal A, Aguilar JC, et al. The EuroHeart Failure survey programme-- a survey on the quality of care among patients with heart failure in Europe, part 1: patient characteristics and diagnosis. European heart journal. 2003 Mar;24(5):442–63.
- Ntep-Gweth M, Zimmermann M, Meiltz A, Kingue S, Ndobo P, Urban P, et al. Atrial fibrillation in Africa: clinical characteristics, prognosis, and adherence to guidelines in Cameroon. Europace : European pacing, arrhythmias, and cardiac electrophysiology: journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology. 2010 Apr;12(4):482–7.
- Zhou Z, Hu D. An epidemiological study on the prevalence of atrial fibrillation in the Chinese population of mainland China. Journal of epidemiology. 2008; 18(5):209–16.
- Chiang CE, Naditch-Brule L, Murin J, Goethals M, Inoue H, O'Neill J, et al. Distribution and risk profile of paroxysmal, persistent, and permanent atrial fibrillation in routine clinical practice: insight from the real-life global survey evaluating patients with atrial fibrillation international registry. Circulation Arrhythmia and electrophysiology. 2012 Aug 01;5(4):632–9.
- Wolf PA, Benjamin EJ, Belanger AJ, Kannel WB, Levy D, D'Agostino RB. Secular trends in the prevalence of atrial fibrillation: The Framingham Study. Am Heart J. 1996 Apr; 131(4):790–5.
- Stewart S, Wilkinson D, Hansen C, Vaghela V, Mvungi R, McMurray J, et al. Predominance of heart failure in the Heart of Soweto Study cohort: emerging challenges for urban African communities. Circulation. 2008 Dec 02; 118(23):2360–7.]
- Ikama MS, Kimbally-Kaky G, Gombet T, Ellenga-Mbolla BF, Dilou-Bassemouka L, Mongo-Ngamani S, et al. [Heart failure in elderly patients in Brazzaville, Congo: clinical and etiologic aspects and outcome] Medecinetropicale: revue du Corps de sante colonial. 2008 Jun;68(3):257–60.
- Ojji DB, Alfa J, Ajayi SO, Mamven MH, Falase AO. Pattern of heart failure in Abuja, Nigeria: an echocardiographic study. Cardiovascular journal of Africa. 2009 Nov-Dec;20(6):349–52.
- Pio M, Afassinou Y, Pessinaba S, Baragou S, N'Djao J, Atta B, et al. Epidémiologie et étiologies des insuffisances cardiaques à Lomé Pan Afr Med J. 2014:18.
- Hernandez AF, Hammill BG, O'Connor CM, Schulman KA, Curtis LH, Fonarow GC. Clinical effectiveness of beta-blockers in heart failure: findings from the OPTIMIZE-HF (Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure) Registry. Journal of the American College of Cardiology. 2009 Jan 13;53(2):184–92.
- -Augou Kouadio Guy Pascal. Insuffisance cardiaque dans la fibrillation atriale : étude comparative épidémio-clinique et thérapeutique en Côte d’Ivoire données 2017. Thèse Med. Côte d’Ivoire.Université Alassane Ouattara de Bouaké ;UFR des Sciences Médicales.2018
- -Guédon-Moreau L, Kacet S.[Atrial fibrillation : challenge of antithrombotic treatment]. Ann Cardiol Angeiol (Paris). 2009 ;58 : S25-30.
- -Scheen A, Lancellotti P. Recommandations européennes pour la prise en charge du diabète, du pré-diabète et des maladies cardio-vasculaires 2ème partie. Gestion des complications cardiaques, cérébro-vasculaires et artériopathiques périphériques. Revue Médicale de Liège. 2013 ;68(12):617- 624.
- -Deedwania PC, Singh BN, Ellenbogen K, Fisher S, Fletcher R, Singh SN.Spontaneous conversion and maintenance of sinus rhythm by amiodarone in patients with heart failure and atrial fibrillation: observations from the vétérans affairs congestive heart failure survival trial of antiarrhythmic therapy (CHF- STAT). The Department of Vétérans Affairs CHF-STAT Investigators. Circulation. 1998 ;98(23) :2574-9.
- -Washam JB, Patel MR.Is There Still a Rôle for Digoxin in the Management of Atrial Fibrillation ?Cuit Cardiol Rep. 2018 ,20(11) :105.
References
Ragbaoui Y, Chehbouni C, El Hammiri A, Epidémiologie de l’association fibrillation atriale et insuffisance cardiaque.Pan Afr Med J. 2017; 26: 116.
Deedwania PC, Lardizabal JA. Atrial fibrillation in heart failure: a comprehensive review. Am J Med. 2010 Mar;123(3):198–204.
Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Blaha MJ, et al. Heart disease and stroke statistics--2014 update: a report from the American Heart Association. Circulation. 2014 Jan 21;129(3):e28–e29. Epub 2013/12/20. Eng.
-M.Thiam.Insuffisance cardiaque en milieu cardiologique afircain.Bull Soc Pathol.Exot, 2003,96,217-8
-M. Pio,E.Goeh-Akue,Y.Afassinou,B.Atta,E.Missihoun,K.Ehlan.Insuffisance cardiaque du sujet jeune: aspects épidémiologiques,cliniques et étiologiques au CHU Sylvanus Olympio de Lomé.Annales de Cardiologie et d’Angéiologie. 2014 Sept.63(4) ;240-44.
Stevenson WG, Stevenson LW. Atrial fibrillation in heart failure. N Engl J Med. 1999 Sep 16; 341(12):910–1.
Cerit L. The Paradox of Heart Failure and Atrial Fibrillation. Journal of the American College of Cardiology. 2016 Sep 13; 68(11):1252–3g.
Maisel WH, Stevenson LW. Atrial fibrillation in heart failure: epidemiology, pathophysiology, and rationale for therapy. Am J Cardiol. 2003 Mar 20; 91(6a):2d–8d.
Cleland JG, Swedberg K, Follath F, Komajda M, Cohen-Solal A, Aguilar JC, et al. The EuroHeart Failure survey programme-- a survey on the quality of care among patients with heart failure in Europe, part 1: patient characteristics and diagnosis. European heart journal. 2003 Mar;24(5):442–63.
Ntep-Gweth M, Zimmermann M, Meiltz A, Kingue S, Ndobo P, Urban P, et al. Atrial fibrillation in Africa: clinical characteristics, prognosis, and adherence to guidelines in Cameroon. Europace : European pacing, arrhythmias, and cardiac electrophysiology: journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology. 2010 Apr;12(4):482–7.
Zhou Z, Hu D. An epidemiological study on the prevalence of atrial fibrillation in the Chinese population of mainland China. Journal of epidemiology. 2008; 18(5):209–16.
Chiang CE, Naditch-Brule L, Murin J, Goethals M, Inoue H, O'Neill J, et al. Distribution and risk profile of paroxysmal, persistent, and permanent atrial fibrillation in routine clinical practice: insight from the real-life global survey evaluating patients with atrial fibrillation international registry. Circulation Arrhythmia and electrophysiology. 2012 Aug 01;5(4):632–9.
Wolf PA, Benjamin EJ, Belanger AJ, Kannel WB, Levy D, D'Agostino RB. Secular trends in the prevalence of atrial fibrillation: The Framingham Study. Am Heart J. 1996 Apr; 131(4):790–5.
Stewart S, Wilkinson D, Hansen C, Vaghela V, Mvungi R, McMurray J, et al. Predominance of heart failure in the Heart of Soweto Study cohort: emerging challenges for urban African communities. Circulation. 2008 Dec 02; 118(23):2360–7.]
Ikama MS, Kimbally-Kaky G, Gombet T, Ellenga-Mbolla BF, Dilou-Bassemouka L, Mongo-Ngamani S, et al. [Heart failure in elderly patients in Brazzaville, Congo: clinical and etiologic aspects and outcome] Medecinetropicale: revue du Corps de sante colonial. 2008 Jun;68(3):257–60.
Ojji DB, Alfa J, Ajayi SO, Mamven MH, Falase AO. Pattern of heart failure in Abuja, Nigeria: an echocardiographic study. Cardiovascular journal of Africa. 2009 Nov-Dec;20(6):349–52.
Pio M, Afassinou Y, Pessinaba S, Baragou S, N'Djao J, Atta B, et al. Epidémiologie et étiologies des insuffisances cardiaques à Lomé Pan Afr Med J. 2014:18.
Hernandez AF, Hammill BG, O'Connor CM, Schulman KA, Curtis LH, Fonarow GC. Clinical effectiveness of beta-blockers in heart failure: findings from the OPTIMIZE-HF (Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure) Registry. Journal of the American College of Cardiology. 2009 Jan 13;53(2):184–92.
-Augou Kouadio Guy Pascal. Insuffisance cardiaque dans la fibrillation atriale : étude comparative épidémio-clinique et thérapeutique en Côte d’Ivoire données 2017. Thèse Med. Côte d’Ivoire.Université Alassane Ouattara de Bouaké ;UFR des Sciences Médicales.2018
-Guédon-Moreau L, Kacet S.[Atrial fibrillation : challenge of antithrombotic treatment]. Ann Cardiol Angeiol (Paris). 2009 ;58 : S25-30.
-Scheen A, Lancellotti P. Recommandations européennes pour la prise en charge du diabète, du pré-diabète et des maladies cardio-vasculaires 2ème partie. Gestion des complications cardiaques, cérébro-vasculaires et artériopathiques périphériques. Revue Médicale de Liège. 2013 ;68(12):617- 624.
-Deedwania PC, Singh BN, Ellenbogen K, Fisher S, Fletcher R, Singh SN.Spontaneous conversion and maintenance of sinus rhythm by amiodarone in patients with heart failure and atrial fibrillation: observations from the vétérans affairs congestive heart failure survival trial of antiarrhythmic therapy (CHF- STAT). The Department of Vétérans Affairs CHF-STAT Investigators. Circulation. 1998 ;98(23) :2574-9.
-Washam JB, Patel MR.Is There Still a Rôle for Digoxin in the Management of Atrial Fibrillation ?Cuit Cardiol Rep. 2018 ,20(11) :105.