Abstract
Atrial fibrillation (AF) is the most common arrhythmia encountered in clinical practice accounting for approximately one-third of hospitalizations for cardiac rhythm disturbances and is associated with increased risk for stroke, heart failure and death. The epidemiology and clinical features of AF have primarily been characterized in whites of European-descent. The world literature on the epidemiology of AF among different ethnicities is very limited with most of the published reports of AF in non-white ethnicities focusing mainly on black (African-American) patients.
The current work represents structured and staged examination of AF in two ethnic groups where very limited literature is available on, namely: Middle Eastern Arabs and South Asians. My original contribution to knowledge includes identification of different aspects of AF in the targeted ethnic groups (Middle Eastern Arabs and South Asians), including: aetiologies; secular trends; cardiovascular risk factors; therapy; and outcome using data from a national registry of cardiovascular diseases in a Middle Eastern country over a 20-years period. In addition, the research undertaken focused on several other aspects peculiar to the effects of AF in these two ethnicities. This included; religious fasting, gender differences, and in high-risk patients including those with chronic kidney disease and acute myocardial infarction.
Results of the work fill literature gaps in the clinical features, management and outcomes of AF in the two targeted ethnicities, which serve as essential background for further research to improve outcomes. Moreover, the work included original contributions to general AF knowledge, namely in relation to the effects of fasting and lack of symptoms at presentations, which enriches the world literature of AF. This thesis includes nine publications; seven original papers, one summary paper, and one literature review paper; all published in peer-reviewed journals.
Description
I. Salam AM, AlBinali HA, Al-Mulla AW, Singh R, Al Suwaidi J. Secular trends, treatments, and outcomes of Middle Eastern Arab and South Asian patients hospitalized with atrial fibrillation: insights from a 20-year registry in Qatar (1991-2010). Angiology. 2013 Oct;64(7):498-504. doi: 10.1177/0003319712460332. Epub 2012 Oct 1. PMID: 23028177.
II. Salam AM, AlBinali HA, Al-Mulla AW, Asaad N, Singh R, Al-Qahtani A, Al Suwaidi J. Women hospitalized with atrial fibrillation: gender differences, trends and outcome from a 20-year registry in a Middle Eastern country (1991-2010). Int J Cardiol. 2013 Sep 30;168(2):975-80. doi: 10.1016/j.ijcard.2012.10.041. Epub 2012 Nov 15. PMID: 23159409.
III. Salam AM, AlBinali HA, Al-Sulaiti EM, Al-Mulla AW, Singh R, Al Suwaidi J. Effect of age on treatment, trends and outcome of patients hospitalized with atrial fibrillation: insights from a 20-years registry in a Middle-Eastern country (1991-2010). Aging Clin Exp Res. 2012 Dec;24(6):682-90. doi: 10.3275/8757. Epub 2012 Nov 26. PMID: 23211770.
IV. Salam AM, Al BH, Singh R, Gehani A, Asaad N, Al-Qahtani A, Suwaidi JA. Atrial fibrillation in Middle Eastern Arab and South Asian patients hospitalized with acute myocardial infarction: experience from a 20-year registry in qatar (1991-2010). Acta Cardiol. 2013 Apr;68(2):173-80. doi: 10.1080/ac.68.2.2967275. PMID: 23705560.
V. Salam AM, Gersh BJ, AlBinali HA, Singh R, Asaad N, Al-Qahtani A, Suwaidi JA. The prognostic implications of lack of palpitations in patients hospitalised with atrial fibrillation: observations from a 20-year registry. Int J Clin Pract. 2014 Jan;68(1):122-9. doi: 10.1111/ijcp.12230. PMID: 24341306.
VI. Salam AM, AlBinali HA, Salim I, Singh R, Asaad N, Al-Qahtani A, Al Suwaidi J. Impact of religious fasting on the burden of atrial fibrillation: a population-based study. Int J Cardiol. 2013 Oct 3;168(3):3042-3. doi: 10.1016/j.ijcard.2013.04.131. Epub 2013 May 1. PMID: 23642825.
VII. Salim I, Al Suwaidi J, AlBinali HA, Singh R, Al-Qahtani A, Asaad N, Salam AM. Impact of Chronic Kidney Disease on the Presentation and Outcome of Patients Hospitalized With Atrial Fibrillation: Insights From Qatar. Angiology. 2018 Mar;69(3):212-219. doi: 10.1177/0003319717717849. Epub 2017 Jul 10. PMID: 28691505.
VIII. Salam AM. Atrial Fibrillation in Middle Eastern Arabs and South Asians: Summary of Published Articles in the Arabian Gulf. Heart Views. 2019 Oct-Dec;20(4):158-165. doi: 10.4103/HEARTVIEWS.HEARTVIEWS_116_19. Epub 2019 Nov 14. PMID: 31803372; PMCID: PMC6881872. [Publications` summary article].
IX. Salam AM, Kaddoura R, Salih V, Asopa S. Atrial fibrillation in Middle Eastern Arabs and South Asians: a scoping review. Rev Cardiovasc Med. 2021;22(4):1185-1196. doi:10.31083/j.rcm2204127 [Literature Review Paper].
Commissioning body
Faculty of Health: Medicine, Dentistry and Human Sciences