The characteristics and clinical outcomes of atrial fibrillation patient in middle income country of Indonesia - Report - MDSpire

The characteristics and clinical outcomes of atrial fibrillation patient in middle income country of Indonesia

  • By

  • Yoga Yuniadi

  • Putra S. Antara

  • Muzakkir Amir

  • Dicky A. Hanafy

  • Sunu B. Raharjo

  • Dony Y. Hermanto

  • M. Yamin

  • Hauda El-Rasyid

  • Benny Setiadi

  • Erika Maharani

  • Agus Harsoyo

  • Anggia C. Lubis

  • Pipin Ardhianto

  • Aruman Y. A. Binarso

  • Ardian Rizal

  • Rerdin Julario

  • Agung F. Chandranegara

  • Yoga Waranugraha

  • Chaerul Ahmad

  • Mohammad Iqbal

  • Ridwan Rasyid

  • Antonia A. Lukito

  • Haryadi Haryadi

  • Margono G. Suwandi

  • Alexander E. Tondas

  • Indah A. Putri

  • Beny Hartono

  • July 1, 2026

  • 0 min

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Clinical Features and Outcomes of Atrial Fibrillation Patients in Indonesia's Middle-Income Context

Overview

This study evaluates the clinical outcomes of atrial fibrillation (AF) patients in Indonesia receiving warfarin therapy. Findings indicate a mean time in therapeutic range of only 30.1%.

Background

Atrial fibrillation is a prevalent arrhythmia and a major risk factor for ischemic stroke and mortality, particularly in Asia. Despite the global shift towards direct oral anticoagulants (DOACs), vitamin K antagonists (VKAs) like warfarin remain the primary treatment in many low- and middle-income countries, including Indonesia. Understanding the clinical outcomes of AF patients in this context is crucial.

Data Highlights

OutcomeIncidence Rate (per 100 patient-years)
Stroke1.32
Major Bleeding1.51
Mortality3.15

Key Findings

  • Mean CHA2DS2-VASc score among participants was 2.43.
  • Mean time in therapeutic range (TTR) was only 30.1% under the standard INR target of 2.0–3.0.
  • Patients with average INR values of 1.6–2.5 had lower rates of stroke and major bleeding.
  • Stroke risk was highest in patients with persistent/permanent AF.
  • Younger, working-age individuals were disproportionately affected by AF-related strokes.

Clinical Implications

The findings indicate that warfarin management at the standard INR target is associated with poor anticoagulation quality.

Conclusion

The study highlights the challenges of managing atrial fibrillation with warfarin in Indonesia.

Related Resources & Content

  1. JAMA Network Open, 2023 -- Health Status Changes and Long-Term Clinical Outcomes in Patients With Atrial Fibrillation
  2. JAMA Network Open, 2023 -- Sex-Based Disparities in Health Care Access and Utilization Among Patients With Atrial Fibrillation
  3. European Journal of Preventive Cardiology, 2023 -- Ethnic differences in clinical outcomes following major bleeding in atrial fibrillation patients
  4. 2024 ESC Guidelines for the management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS)
  5. Clinical Research in Cardiology — Patterns of Atrial Fibrillation and Associated Cardiovascular Risk Factors in the General Population: Insights from the Rotterdam Study
  6. 2024 ESC Guidelines for the management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS)
  7. Dabigatran versus Warfarin in Patients with Atrial Fibrillation | New England Journal of Medicine
  8. The COOL-AF Phase 2 Registry: COhort of Antithrombotic Use and Clinical Outcomes in Atrial Fibrillation Patients - PMC

Original Source(s)

The characteristics and clinical outcomes of atrial fibrillation patient in middle income country of Indonesia

  • by Yoga Yuniadi, Putra S. Antara, Muzakkir Amir, Dicky A. Hanafy, Sunu B. Raharjo, Dony Y. Hermanto, M. Yamin, Hauda El-Rasyid, Benny Setiadi, Erika Maharani, Agus Harsoyo, Anggia C. Lubis, Pipin Ardhianto, Aruman Y. A. Binarso, Ardian Rizal, Rerdin Julario, Agung F. Chandranegara, Yoga Waranugraha, Chaerul Ahmad, Mohammad Iqbal, Ridwan Rasyid, Antonia A. Lukito, Haryadi Haryadi, Margono G. Suwandi, Alexander E. Tondas, Indah A. Putri, Beny Hartono

  • July 1, 2026

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