ArticleBMJ open2022
Atrial fibrillation and mortality in outpatients with heart failure in Tanzania: a prospective cohort study.
Article in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Article
- Development and validation of a machine learning model integrating BUN/Cr ratio for mortality prediction in critically ill atrial fibrillation patients.Scientific reports · 2025Article
- Clinical epidemiology of atrial fibrillation in heart failure in Abeokuta, Nigeria.Heart rhythm O2 · 2025Article
- Hospitalization outcomes in people living with HIV on Dolutegravir-based regimen in Mwanza, Tanzania: a comparative cohort.AIDS research and therapy · 2025Article
- Rural-Urban Differences in Outcomes of Acute Cardiac Admissions in a Large Health Service.JACC. Advances · 2024Article
- Peer Counselor Intervention for Reducing Mortality and/or Hospitalization in Adults With Hypertensive Urgency in Tanzania: A Pilot Study.American journal of hypertension · 2023Article
- Heart failure with reduced ejection fraction and atrial fibrillation: a Sub-Saharan African perspective.ESC heart failure · 2023Review
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8 authors.
Funding
Abstract
objectiveIn recent years, the prevalence and mortality of heart failure (HF) and other associated cardiovascular diseases have doubled in sub-Saharan Africa (SSA). Studies in high-income countries indicate that HF with concurrent atrial fibrillation (AF) is linked to increased mortality. Our objective was to determine the incidence and clinical outcomes of AF among patients with HF in SSA.
designA prospective cohort study using data collected between October 2018 and May 2020.
settingOutpatient clinic at a tertiary hospital in Mwanza, Tanzania.
participants303 adult participants (aged ≥18 years) with HF as defined by the European Society of Cardiology guidelines (2016) and 100 adults with HF as defined by clinical criteria alone were enrolled into the study. Patients with comorbid medical condition that had prognosis of <3 months (ie, advance solid tumours, advance haematological malignancies) were excluded.
methodsParticipants were screened for AF, and their medical history, physical examinations and sociodemographic information were obtained. Multivariable logistic regression models were used to examine factors associated with AF incidence. Cox regression models were used to analyse 3-month mortality and its associated risk factors.
resultsWe enrolled 403 participants with HF (mean age 60±19 years, 234 (58%) female). The AF prevalence was 17%. In multivariable models, factors associated with AF were low income, alcohol consumption and longer duration of HF. At the end of the 3-month follow-up, 120 out of 403 (30%) participants died, including 44% (31/70) of those with AF. Higher heart rate on ECG, more severe New York Heart Association HF class, rural residence and anaemia were significantly correlated with mortality.
conclusionAF is common, underdiagnosed and is associated with significant mortality among outpatients with HF in Tanzania (HR 1.749, 95% CI 1.162 to 2.633, p=0.007). Our findings additionally identify tachycardia (>110 bpm, HR 1.879, 95% CI 1.508 to 2.340, p<0.001) as an easily measurable, high-impact physical examination finding for adverse outcomes in patients with HF.
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