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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 30, No 3, May/June 2019
170
AFRICA
patients with non-valvular AF, patients with valvular AF were
significantly younger (
p
<
0.001) and more likely to be female (
p
=
0.003). They were less likely to have hypertension (
p
<
0.001),
chronic kidney disease (
p
<
0.02) and a previous stroke/TIA (
p
<
0.017). Participants with valvular AF had significantly larger
left atrial diameter (
p
<
0.001) than the non-valvular AF patients.
Table 1. Baseline characteristics of AF patients at Princess Marina
Hospital, Botswana, between August 2016 and July 2018
Characteristics
All patients (
n
=
138)
Gender, female,
n
(%)
88 (63.8)
Mean age, years ( SD)
66.7 (17.2)
Age groups
<
65 years,
n
(%)
55 (39.9)
65–74 years,
n
(%)
32 (23.1)
> 75 years,
n
(%)
51 (37.0)
Stroke risk factors
Hypertension,
n
(%)
82 (59.4)
Heart failure,
n
(%)
49 (35.5)
Stroke/TIA,
n
(%)
30 (21.7)
Diabetes mellitus,
n
(%)
11 (8.0)
Age > 75 years,
n
(%)
51 (37.0)
Other clinical data
Rheumatic heart disease,
n
(%)
52 (37.7)
Prosthetic valves,
n
(%)
25 (18.1)
Current smoking,
n
(%)
13 (9.4)
Chronic kidney disease,
n
(%)
21 (15.2)
Alcohol consumption,
n
(%)
7 (5.1)
Mean heart rate (beats/min), mean (SD)
83.9 (24.9)
Systolic blood pressure (mmHg), mean (SD)
126.6 (21.1)
Diastolic blood pressure (mmHg), mean (SD)
78 (13.2)
BMI (kg/m
2
), mean (SD)
28.72 (6.7)
BMI
≥
30 kg/m
2
,
n
(%)
48 (34.8)
Laboratory results
Haemoglobin (g/dl), mean (SD)
12.9 (1.9)
eGFR (ml/min/1.73 m
2
), median (Q1, Q3)
75.9 (69.1–113.5)
Uric acid (µmol/l), median (Q1, Q3)
310 (271–387)
AST (U/l), median (Q1, Q3)
28.6 (21.3–47.3)
ALT (U/l), median(Q1, Q3)
20.4 (14.1–43.8)
ALP (U/l), median (Q1, Q3)
94.0 (69.0–120.0)
GGT (U/l), median (Q1, Q3)
77.5 (37.8–133.3)
Echocardiography
LVEF (%), mean (SD)
52.8 (17.7)
LA (cm), mean (SD)
4.8 (1.0)
LVDd (cm), mean (SD)
4.7 (1.0)
PASP (mmHg), median (IQR)
33.5 (25–48.2)
CHA
2
DS
2
-VASc score, mean (SD)
3.6 (1.5)
HAS-BLED, median (Q1, Q3)
2.0 (1.0–3.0)
Medications at enrolment
Anticoagulation,
n
(%)
101 (73.2)
Warfarin,
n
(%)
95 (68.8)
NOAC (only dabigatran available),
n
(%)
6 (4.4)
Aspirin,
n
(%)
19 (13.8)
Digoxin,
n
(%)
44 (31.9)
Beta-blocker,
n
(%)
97 (70.3)
ACE inhibitors,
n
(%)
51 (37.0)
Furosemide,
n
(%)
92 (66.7)
Spironolactone,
n
(%)
52 (37.7)
ACE, angiotensin converting enzyme; ALT, alanine aminotransferase; ALP,
alkaline phosphatase; AST, aspartate aminotransferase; BMI, body mass index;
eGFR, glomerular filtration rate; IQR, interquartile range; GGT, gamma-
glutamyl transpeptidase; LA, left atrium; LVDd, left ventricular diastolic diam-
eter; LVEF, left ventricular ejection fraction; NOAC, non‐vitamin K antagonist
oral anticoagulant; PASP, peak arterial systolic pressure; Q, quartile; SD, stan-
dard deviation.
Table 2. Clinical and biomedical data in valvular and non-valvular AF
patients at Princess Marina Hospital, Botswana
Characteristics
Non-valvular AF
(
n
=
94)
Valvular AF
(
n
=
44
p-
value
Gender, female,
n
(%)
52 (55.3)
36 (81.8)
0.003
Age, years, median
(Q1, Q3)
74.5 (64.5–83.0)
59.5 (41.3–65.0)
<
0.001
Age group,
n
(%)
<
65 years,
n
(%)
23 (24.5)
32 (72.7)
<
0.001
65–74 years,
n
(%)
24 (25.5)
8 (18.2)
> 75 years,
n
(%)
47 (50.0)
4 (9.1)
Hypertension,
n
(%)
68 (71.6)
14 (32.6)
<
0.001
Diabetes mellitus,
n
(%)
10 (10.6)
1 (2.3)
0.091
Prosthetic valves,
n
(%)
N/A
25 (56.8)
N/A
Rheumatic heart disease,
n
(%)
33 (35.1)
19 (43.2)
0.362
Heart failure,
n
(%)
37 (39.4)
12 (27.3)
0.167
Stroke/TIA,
n
(%)
26 (27.4)
4 (9.3)
0.017
Current smoking,
n
(%)
12 (12.8)
1 (2.3)
0.049
Chronic kidney disease,
n
(%)
19 (20.0)
2 (4.7)
0.020
Alcohol consumption,
n
(%)
6 (6.3)
1 (2.3)
0.322
Mean heart rate,
beats/min, mean (SD)
82.5 (24.6)
86.9 (25.8)
0.357
Diastolic blood pressure
(mmHg), mean (SD)
77.5 (14.5)
79.5 (9.8)
0.419
Systolic blood pressure
(mmHg), mean (SD)
128.2 (22.5)
123.4 (17.8)
0.190
BMI (kg/m
2
), mean (SD)
29.0 (6.5)
28.2 (7.1)
0.530
BMI
≥
30 kg/m
2
,
n
(%)
33 (35.1)
15 (34.1)
0.907
Laboratory results
Haemoglobin(g/dl),
mean (SD)
13.2 (1.7)
12.5 (2.0)
0.080
eGFR (ml/min/1.73
m
2
),median (Q1, Q3)
82.8 (65.2–115.1)
95.9 (73.9–112.4)
0.066
Uric acid (µmol/l),
median (Q1, Q3)
310.0 (271.8–399.8) 314.0 (269.0–383.0)
0.789
AST (U/l), median
(Q1, Q3)
27.1 (20.0–41.0)
36.0 (26.0–66.5)
0.006
ALT (U/l), median
(Q1, Q3)
20.0 (12.0–35.0)
31.0 (17.0–62.5)
0.009
ALP
88.5 (67.3–117.8)
96.0 (78.0–125.0)
0.301
GGT
77.5 (30.3–111.4)
76.5 (58.3–143.0)
0.207
Echocardiography
LVEF (%), mean (SD)
52.3 (18.2)
53.8 (16.7)
0.651
LA (cm), mean (SD)
4.5 (0.9)
5.3 (1.0)
<
0.001
LVDd (cm), mean (SD)
4.8 (1.0)
4.8 (1.0)
0.801
PASP (mmHg), median
(IQR)
32.5 (22–48.2)
35.5 (26–48.4)
0.463
CHA
2
DS
2
-VASc score,
mean (SD)
3.6 (1.5)
N/A
N/A
HAS-BLED, median (IQR)
2.0 (2.0–3.0)
0.5 (0–2.0)
<
0.001
Medications at enrolment
Anticoagulation,
n
(%)
62 (66.0)
39 (88.6)
0.005
Aspirin,
n
(%)
16 (16.8)
3 (7.0)
0.119
Digoxin,
n
(%)
28 (29.8)
16 (36.4)
0.440
Beta-blocker,
n
(%)
68 (72.3)
29 (65.9)
0.441
ACE inhibitors,
n
(%)
37 (39.4)
14 (31.8)
0.392
Furosemide,
n
(%)
61 (64.9)
31 (70.5)
0.518
Spironolactone,
n
(%)
35 (37.2)
17 (38.6)
0.874
Dabigatran,
n
(%)
7 (7.4)
0
N/A
ACE, angiotensin converting enzyme; ALT, alanine aminotransferase; ALP,
alkaline phosphatase; AST, aspartate aminotransferase; BMI, body mass index;
eGFR, glomerular filtration rate; IQR, interquartile range; GGT, gamma
glutamyl transpeptidase; LA, left atrium; LVDd, left ventricular diastolic diam-
eter; LVEF, left ventricular ejection fraction; NOAC, non‐vitamin K antagonist
oral anticoagulant; PASP, peak arterial systolic pressure; Q, quartile; SD, stan-
dard deviation.