Relation of changes in ABC pathway compliance status to clinical outcomes in patients with atrial fibrillation: A report from the COOL-AF registry.

IF 5.4 3区材料科学 Q2 CHEMISTRY, PHYSICAL ACS Applied Energy Materials Pub Date : 2024-05-24 DOI:10.1093/ehjqcco/qcae039

Rungroj Krittayaphong, Ply Chichareon, Komsing Methavigul, Sukrit Treewaree, Gregory Y H Lip

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Abstract

Aim: The Atrial fibrillation Better Care (ABC) pathway provides a framework for holistic care management of atrial fibrillation (AF) patients. This study aimed to determine the impact of changes in compliance to ABC pathway management on clinical outcomes.

Methods: This is a prospective multicenter AF registry. Patients with non-valvular AF were enrolled and follow-up for 3 years. Baseline and follow-up compliance to the ABC pathway was assessed. The main outcomes were all-cause death, ischemic stroke/systemic embolism (SSE), major bleeding, and heart failure.

Results: There studied 3096 patients (mean age 67.6 ± 11.1 years, 41.8% female). Patients were categorized into 4 groups: Group 1: ABC compliant at baseline and 1 year [n = 1022 (33.0%)]; Group 2: ABC non-compliant at baseline but compliant at 1 year [n = 307 (9.9%)]; Group 3: ABC compliant at baseline and non-compliant at 1 year [n = 312 (10.1%)]; and Group 4: ABC non-compliant at baseline and also at 1 year [n = 1455 (47.0%)]. The incidence rates (95% confidence intervals, CI) of the composite outcome for Group 1 to 4 were 5.56 (4.54-6.74), 7.42 (5.35-10.03), 9.74 (7.31-12.70), and 11.57 (10.28-12.97), respectively. With Group 1 as a reference, Group 2-4 had hazard ratios (95% CI) of the composite outcome of 1.32 (0.92-1.89), 1.75 (1.26-2.43), and 2.07 (1.65-2.59), respectively.

Conclusion: Re-evaluation of compliance status of the ABC pathway management is needed to optimize integrated care management and improve clinical outcomes. AF patients who were ABC pathway compliant at baseline and also at follow-up had the best clinical outcomes.

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心房颤动患者 ABC 通路顺应状态的变化与临床预后的关系：COOL-AF 登记报告。

目的：心房颤动更好护理（ABC）路径为心房颤动（AF）患者的整体护理管理提供了一个框架。本研究旨在确定ABC路径管理合规性的变化对临床结果的影响：这是一项前瞻性多中心房颤登记研究。方法：这是一项前瞻性多中心房颤登记研究，非瓣膜性房颤患者被纳入研究并随访3年。对ABC路径的基线和随访依从性进行评估。主要结果为全因死亡、缺血性中风/系统性栓塞（SSE）、大出血和心力衰竭：共研究了 3096 名患者（平均年龄为 67.6 ± 11.1 岁，41.8% 为女性）。患者分为 4 组：第 1 组：基线和 1 年符合 ABC 标准 [n = 1022 (33.0%)]；第 2 组：基线和 1 年不符合 ABC 标准 [n = 1022 (33.0%)]：第 2 组：基线时不符合 ABC 标准，但 1 年后符合标准 [n = 307 (9.9%)]；第 3 组：基线时符合 ABC 标准，1 年后不符合标准 [n = 312 (10.1%)]；第 4 组：基线时不符合 ABC 标准，1 年后也不符合标准 [n = 1455 (47.0%)]。第 1 组至第 4 组的综合结果发生率（95% 置信区间，CI）分别为 5.56（4.54-6.74）、7.42（5.35-10.03）、9.74（7.31-12.70）和 11.57（10.28-12.97）。以第 1 组为参照，第 2-4 组的综合结果危险比（95% CI）分别为 1.32（0.92-1.89）、1.75（1.26-2.43）和 2.07（1.65-2.59）：结论：需要重新评估ABC路径管理的依从性状况，以优化综合护理管理并改善临床预后。基线和随访时均符合ABC路径的房颤患者临床疗效最佳。

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来源期刊

ACS Applied Energy Materials Materials Science-Materials Chemistry

CiteScore

10.30

自引率

6.20%

发文量

1368

期刊介绍： ACS Applied Energy Materials is an interdisciplinary journal publishing original research covering all aspects of materials, engineering, chemistry, physics and biology relevant to energy conversion and storage. The journal is devoted to reports of new and original experimental and theoretical research of an applied nature that integrate knowledge in the areas of materials, engineering, physics, bioscience, and chemistry into important energy applications.