Key result
Adhering to 4S-AF and ABC pathways is linked to ~81% fewer deaths or thromboembolic events.
Why the study?
The 4S-AF scheme and ABC pathway have been proposed to better characterize and treat AF patients, but their assessment in Chinese AF patients was needed.
Does management guided by the 4S-AF scheme and ABC pathway reduce all-cause death and thromboembolic events in patients with atrial fibrillation?
Observational (n=6,419)
Yes
Does management guided by the 4S-AF scheme and ABC pathway reduce all-cause death and thromboembolic events in patients with atrial fibrillation?
Answers are grounded in this paper and cite their sources.
Integrated care using the 4S-AF scheme and ABC pathway is associated with significantly improved clinical outcomes, including reduced mortality and thromboembolic events, in patients with atrial fibrillation.
BACKGROUND: The 4S-AF scheme and the ABC pathway for integrated care have been proposed to better characterize and treat patients with atrial fibrillation (AF). We aimed to evaluate the assessment of the 4S-AF scheme and ABC pathway in Chinese AF patients. METHODS: The ChiOTEAF is a prospective, observational, multicentre registry. Consecutive AF patients from 44 centres across 20 Chinese provinces with available 1-year follow-up data were included. RESULTS: A total of 6419 patients were included, median age 76 years (interquartile range 67-83; 39.1% female). Of these, 3503 (59.8%) patients were not characterized using the 4S-AF scheme and not management according to the ABC pathway (group 1); 1795 (28.0%) were characterized according to the 4S-AF scheme but ABC pathway non-adherent or vice versa (group 2); and 1121 (17.4%) characterized according to the 4S-AF scheme and were ABC pathway adherent (group 3). As compared with group 1, group 2 and group 3 were independently associated with lower odds of the composite endpoint of all-cause death/any thromboembolic event, with the greatest benefit observed in group 3 (OR: 0.19; 95% CI 0.12-0.31) [for group 2: OR: 0.28; 95% CI 0.20-0.37]. Similar results were observed for all-cause death (group 2: OR: 0.18; 95% CI 0.12-0.27; group 3: OR: 0.14; 95% CI 0.07-0.25). CONCLUSIONS: In a contemporary real-word cohort of Chinese AF patients, it is feasible to characterize and manage AF patients using the novel 4S-AF scheme and ABC pathway for integrated care. The use of both these tools is associated with improved clinical outcomes.
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Guo et al. (2022) conducted an observational in Atrial fibrillation (n=6,419). 4S-AF scheme and ABC pathway adherence vs. Non-adherence to both 4S-AF scheme and ABC pathway was evaluated on Composite endpoint of all-cause death/any thromboembolic event (OR 0.19, 95% CI 0.12-0.31). Adherence to both the 4S-AF scheme and ABC pathway was associated with lower odds of all-cause death or thromboembolic events compared to non-adherence (OR 0.19; 95% CI 0.12-0.31).
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