Key result
ABC pathway-adherent management was associated with a lower risk of all-cause death or any thromboembolic event compared with nonadherent care (1.5% vs 3.6%; OR 0.51; 95% CI 0.31-0.84; P<0.01).
Why the study?
The ABC pathway has been proposed to streamline integrated AF care, but patient characteristics, adverse event incidence, and its impact on outcomes needed evaluation.
Does Atrial fibrillation Better Care (ABC) pathway-adherent management reduce the composite of all-cause death or thromboembolic events in Chinese patients with atrial fibrillation?
Cohort (n=3,520)
Yes
Does Atrial fibrillation Better Care (ABC) pathway-adherent management reduce the composite of all-cause death or thromboembolic events in Chinese patients with atrial fibrillation?
Odds Ratio: 0.51 (95% CI 0.31–0.84)
Absolute Event Rate: 1.5% vs 3.6%
p-value: p=<0.01
Adherence to the ABC pathway in Chinese patients with atrial fibrillation is associated with a significantly lower risk of all-cause death or thromboembolic events at 1 year.
ABC-adherent care was associated with lower event rates in Chinese AF patients; supports integrated care but leaves open need for randomized confirmation.
Atrial fibrillation (AF) is a complex disease associated with comorbidities and adverse outcomes. The Atrial fibrillation Better Care (ABC) pathway has been proposed to streamline the integrated and holistic approach to AF care. This study sought to evaluate patients’ characteristics, incidence of adverse events, and impact on outcomes with ABC pathway–adherent management. The study included consecutive AF patients enrolled in the nationwide, ChioTEAF registry (44 centers, 20 Chinese provinces from October 2014 to December 2018), with available data to evaluate the ABC criteria and on the 1-year follow-up. A total of 3,520 patients (mean age 73.1 ± 10.4 years, 43% female) were included, of which 1,448 (41.1%) were managed as ABC pathway adherent. The latter were younger and had comparable CHA2DS2-VASc and lower HAS-BLED (mean 71.7 ± 10.3 years of age vs 74.1 ± 10.4 years of age; P < 0.01; 3.54 ± 1.60 vs 3.44 ± 1.70; P = 0.10; and 1.95 ± 1.10 vs 2.12 ± 1.20; P < 0.01, respectively) scores compared with ABC-nonadherent patients. At 1-year follow-up, patients managed adherent to the ABC pathway had a lower incidence of the primary composite outcome of all-cause death or any thromboembolic event (1.5% vs 3.6%; P < 0.01) as compared with ABC-nonadherent patients. On multivariate analysis, ABC pathway–adherent care was independently associated with a lower risk of the composite endpoint (OR: 0.51; 95% CI: 0.31-0.84). Adherence to the ABC pathway for integrated care in a contemporary nationwide cohort of Chinese AF patients was suboptimal. Clinical management adherent to the ABC pathway was associated with better outcomes.
No takes yet. Share an insight, caveat, or question.
Guo et al. (2022) conducted a cohort in Atrial fibrillation (n=3,520). ABC pathway-adherent management vs. ABC-nonadherent management was evaluated on Composite outcome of all-cause death or any thromboembolic event (OR 0.51, 95% CI 0.31-0.84, p=<0.01). ABC pathway-adherent management was associated with a lower risk of all-cause death or any thromboembolic event compared with nonadherent care (1.5% vs 3.6%; OR 0.51; 95% CI 0.31-0.84; P<0.01).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: