Patients’ characteristics and six-month outcomes of patients with atrial fibrillation in Kenya: a retrospective observational cohort study from the National Cardiovascular Registry

Introduction: atrial fibrillation is increasingly diagnosed in Kenya due to the persistence of rheumatic heart disease and the rising burden of cardiovascular risk factors. We aim to describe the baseline, clinical, treatment characteristics, and six-month outcomes of patients diagnosed with atrial fibrillation in Kenya. Methods: a retrospective observational cohort study design was employed. Data were obtained from three Kenyan referral hospitals, including public and private institutions. Baseline and six-month data were collected. Depending on the type of variable, data were summarized descriptively. Results: two hundred forty participants were enrolled, with a median age of 59.0 (IQR: 42.0-75.8). Women made up 54.4% (n=123) of the cohort. The median body mass index was 24.8 kg/m^²(IQR: 21.1-29.2), and 62.8% (n=142) of participants were hospitalized at enrollment. Non-valvular atrial fibrillation (AF) was the predominant type, accounting for 77.4% (n=175) of cases, with persistent AF being the most common subtype (60.5%, n=137). At baseline, 77% (n=174) of participants were on anticoagulation therapy. The proportion with high-risk HAS-BLED and CHA₂ DS₂-VASc scores at baseline was 10 (4.4%) and 62 (28.8%), respectively. Hypertension was the most prevalent comorbidity, affecting 39.4% (n=89) of participants. Nearly half (48.6%) had a preserved left ventricular ejection fraction. At the six-month follow-up, all participants remained on anticoagulation therapy. Mortality occurred in 17.7% (n=40) of participants, with cardiovascular causes accounting for 45.0% of these deaths. Conclusion: the predominant type was non-valvular atrial fibrillation. Enhancing screening for comorbidities and adopting a holistic approach to atrial fibrillation care could lead to better patient outcomes in Kenya.