ArticleFrontiers in cardiovascular medicine2026
The characteristics and clinical outcomes of atrial fibrillation patient in middle income country of Indonesia.
Article in Frontiers in cardiovascular medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Atrial fibrillation (AF) is an increasing health concern in Asia, but data from developing countries remain scarce. Although direct oral anticoagulants (DOACs) are now preferred globally, vitamin K antagonists (VKAs) remain the mainstay of stroke prevention in low- and middle-income countries, including Indonesia. This study evaluates the clinical outcomes of Indonesian AF patients with warfarin-based treatment. Methods: The OPTIMA (Optimal target of INR for Indonesian) study is a multicenter, prospective cohort study involving 1,599 AF patients across 25 centers in Indonesia. Clinical characteristics, INR levels, and time in therapeutic range (TTR) were analyzed. The primary endpoints were stroke/systemic embolism (efficacy) and major bleeding (safety). Cox proportional hazards regression and Kaplan-Meier analysis assessed outcomes. Results: The mean CHA Conclusions: Warfarin management at the standard INR target of 2.0-3.0 was associated with poor anticoagulation quality. Patients with average INR values of 1.6-2.5 experienced fewer adverse events, although this finding requires confirmation in prospective trials. Socioeconomic burden is substantial, as AF-related stroke disproportionately affects younger, working-age Indonesians.
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