TY - JOUR
T1 - Relation of outcomes to ABC (Atrial Fibrillation Better Care) pathway adherent care in European patients with atrial fibrillation
T2 - an analysis from the ESC-EHRA EORP Atrial Fibrillation General Long-Term (AFGen LT) Registry
AU - Proietti, Marco
AU - Lip, Gregory Y H
AU - Laroche, Cécile
AU - Fauchier, Laurent
AU - Marin, Francisco
AU - Nabauer, Michael
AU - Potpara, T
AU - Dan, Gheorghe-Andrei
AU - Kalarus, Zbigniew
AU - Tavazzi, Luigi
AU - Maggioni, Aldo Pietro
AU - Boriani, Giuseppe
AU - ESC-EORP Atrial Fibrillation General Long-Term Registry Investigators Group
AU - Potpara, T
AU - Lenarczyk, R
A2 - Boriani, G
A2 - Lip, G Y H
A2 - Tavazzi, L
A2 - Maggioni, A P
A2 - Dan, G-A
A2 - Nabauer, M
A2 - Marin, F
A2 - Kalarus, Z
A2 - Fauchier, L
A2 - Ferrari, R
A2 - Shantsila, A
A2 - Goda, A
A2 - Mairesse, G
A2 - Shalganov, T
A2 - Antoniades, L
A2 - Taborsky, M
A2 - Riahi, S
A2 - Muda, P
A2 - García Bolao, I
A2 - Piot, O
A2 - Nabauer, M
A2 - Etsadashvili, K
A2 - Simantirakis, E
A2 - Haim, M
A2 - Azhari, A
A2 - Najafian, J
A2 - Santini, M
A2 - Mirrakhimov, E
A2 - Kulzida, K A
A2 - Erglis, A
A2 - Poposka, L
A2 - Burg, M
A2 - Crijns, H
A2 - Erküner, Ö
A2 - Atar, D
A2 - Martins Oliveira, M
A2 - Kalējs, Oskars
A2 - Jubele, Kristine
N1 - Full list of ESC-EORP Atrial Fibrillation General Long-Term Registry Investigators is provided in the Appendix of the article, online version. List of Investigators can not be seen in Scopus and Web of Science.
Publisher Copyright:
Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2020. For permissions, please email: [email protected].
PY - 2021/2
Y1 - 2021/2
N2 - AIMS: There has been an increasing focus on integrated, multidisciplinary, and holistic care in the treatment of atrial fibrillation (AF). The 'Atrial Fibrillation Better Care' (ABC) pathway has been proposed to streamline integrated care in AF. We evaluated the impact on outcomes of an ABC adherent management in a contemporary real-life European-wide AF cohort. METHODS AND RESULTS: Patients enrolled in the ESC-EHRA EURObservational Research Programme in AF General Long-Term Registry with baseline data to evaluate ABC criteria and available follow-up data were considered for this analysis. Among the original 11 096 AF patients enrolled, 6646 (59.9%) were included in this analysis, of which 1996 (30.0%) managed as ABC adherent. Patients adherent to ABC care had lower CHA2DS2-VASc and HAS-BLED scores (mean ± SD, 2.68 ± 1.57 vs. 3.07 ± 1.90 and 1.26 ± 0.93 vs. 1.58 ± 1.12, respectively; P < 0.001). At 1-year follow-up, patients managed adherent to ABC pathway compared to non-adherent ones had a lower rate of any thromboembolic event (TE)/acute coronary syndrome (ACS)/cardiovascular (CV) death (3.8% vs. 7.6%), CV death (1.9% vs. 4.8%), and all-cause death (3.0% vs. 6.4%) (all P < 0.0001). On Cox multivariable regression analysis, ABC adherent care showed an association with a lower risk of any TE/ACS/CV death [hazard ratio (HR): 0.59, 95% confidence interval (CI): 0.44-0.79], CV death (HR: 0.52, 95% CI: 0.35-0.78), and all-cause death (HR: 0.57, 95% CI: 0.43-0.78). CONCLUSION: In a large contemporary cohort of European AF patients, a clinical management adherent to ABC pathway for integrated care is associated with a significant lower risk for cardiovascular events, CV death, and all-cause death.
AB - AIMS: There has been an increasing focus on integrated, multidisciplinary, and holistic care in the treatment of atrial fibrillation (AF). The 'Atrial Fibrillation Better Care' (ABC) pathway has been proposed to streamline integrated care in AF. We evaluated the impact on outcomes of an ABC adherent management in a contemporary real-life European-wide AF cohort. METHODS AND RESULTS: Patients enrolled in the ESC-EHRA EURObservational Research Programme in AF General Long-Term Registry with baseline data to evaluate ABC criteria and available follow-up data were considered for this analysis. Among the original 11 096 AF patients enrolled, 6646 (59.9%) were included in this analysis, of which 1996 (30.0%) managed as ABC adherent. Patients adherent to ABC care had lower CHA2DS2-VASc and HAS-BLED scores (mean ± SD, 2.68 ± 1.57 vs. 3.07 ± 1.90 and 1.26 ± 0.93 vs. 1.58 ± 1.12, respectively; P < 0.001). At 1-year follow-up, patients managed adherent to ABC pathway compared to non-adherent ones had a lower rate of any thromboembolic event (TE)/acute coronary syndrome (ACS)/cardiovascular (CV) death (3.8% vs. 7.6%), CV death (1.9% vs. 4.8%), and all-cause death (3.0% vs. 6.4%) (all P < 0.0001). On Cox multivariable regression analysis, ABC adherent care showed an association with a lower risk of any TE/ACS/CV death [hazard ratio (HR): 0.59, 95% confidence interval (CI): 0.44-0.79], CV death (HR: 0.52, 95% CI: 0.35-0.78), and all-cause death (HR: 0.57, 95% CI: 0.43-0.78). CONCLUSION: In a large contemporary cohort of European AF patients, a clinical management adherent to ABC pathway for integrated care is associated with a significant lower risk for cardiovascular events, CV death, and all-cause death.
KW - Atrial fibrillation
KW - Integrated care
KW - Outcomes
KW - Registry
UR - http://www.scopus.com/inward/record.url?scp=85102090625&partnerID=8YFLogxK
U2 - 10.1093/europace/euaa274
DO - 10.1093/europace/euaa274
M3 - Article
SN - 1099-5129
VL - 23
SP - 174
EP - 183
JO - Europace
JF - Europace
IS - 2
ER -