Integrated Care of Atrial Fibrillation Using the ABC (Atrial fibrillation Better Care) Pathway Improves Clinical Outcomes in Chinese Population: An Analysis From the Chinese Atrial Fibrillation Registry
Background: “Atrial fibrillation Better Care” (ABC) pathway has been proposed to improve the management of patients suffered from atrial fibrillation (AF). This integrated or holistic management approach comprise of three aspects, including “A” Avoid stroke or Anticoagulation; “B” Better symptom con...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2021-11-01
|
| Series: | Frontiers in Cardiovascular Medicine |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2021.762245/full |
| _version_ | 1818856456449949696 |
|---|---|
| author | Yu-Feng Wang Chao Jiang Liu He Xin Du Xin Du Xin Du Cai-Hua Sang De-Yong Long De-Yong Long Ri-Bo Tang Jian-Zeng Dong Gregory Y. H. Lip Chang-Sheng Ma |
| author_facet | Yu-Feng Wang Chao Jiang Liu He Xin Du Xin Du Xin Du Cai-Hua Sang De-Yong Long De-Yong Long Ri-Bo Tang Jian-Zeng Dong Gregory Y. H. Lip Chang-Sheng Ma |
| author_sort | Yu-Feng Wang |
| collection | DOAJ |
| description | Background: “Atrial fibrillation Better Care” (ABC) pathway has been proposed to improve the management of patients suffered from atrial fibrillation (AF). This integrated or holistic management approach comprise of three aspects, including “A” Avoid stroke or Anticoagulation; “B” Better symptom control with rate or rhythm control strategies; “C” Cardiovascular risk factor and Concomitant diseases management. We aimed to confirm the beneficial evidence of ABC pathway compliance in a Chinese AF cohort.Method and Results: From the Chinese Atrial Fibrillation registry (CAFR) dataset, a total of 19,187 non-valvular AF patients were enrolled, of which 4.365 (22.8%) were ABC pathway compliant (ABC compliance group). During a median follow-up of 4.1 ± 1.8 years, The incident rate of all-cause death in ABC compliance group and non-ABC compliance group is 2.7 and 1.1 per 100 person-year (p < 0.001), the incident rate of ischemic stroke is 1.3 and 0.8% per 100 person-year (p < 0.001), the incident rate of composite outcome, which consist of all-cause death, ischemic stroke and intracranial hemorrhage, is 3.8 and 1.9 per 100 person-year (p < 0.001). On Cox multivariable analysis, ABC pathway shows an independently association with reduction of all-cause death [hazard ratio (HR) = 0.82; 95% confidence interval (CI) = 0.70–0.95] and the composite outcome (HR 0.86, 95% CI 0.76–0.96). The increasingly components of ABC integrated care compliance is associated with lower risk of all-cause death and composite events.Conclusion: In a large cohort of Chinese AF patients, ABC pathway compliance shows an independently association with reduction of all-cause death and composite outcome of all-cause death, ischemic stroke and intracranial hemorrhage. Better compliance of ABC integrated care contributes to lower HR for adverse events. |
| first_indexed | 2024-12-19T08:24:47Z |
| format | Article |
| id | doaj.art-19b8c8b5edcc43dea3c104dea9e9e0d8 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-12-19T08:24:47Z |
| publishDate | 2021-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-19b8c8b5edcc43dea3c104dea9e9e0d82022-12-21T20:29:19ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2021-11-01810.3389/fcvm.2021.762245762245Integrated Care of Atrial Fibrillation Using the ABC (Atrial fibrillation Better Care) Pathway Improves Clinical Outcomes in Chinese Population: An Analysis From the Chinese Atrial Fibrillation RegistryYu-Feng Wang0Chao Jiang1Liu He2Xin Du3Xin Du4Xin Du5Cai-Hua Sang6De-Yong Long7De-Yong Long8Ri-Bo Tang9Jian-Zeng Dong10Gregory Y. H. Lip11Chang-Sheng Ma12Department of Cardiology, Beijing AnZhen Hospital, Capital Medical University, National Clinical Research Centre for Cardiovascular Diseases, Beijing, ChinaDepartment of Cardiology, Beijing AnZhen Hospital, Capital Medical University, National Clinical Research Centre for Cardiovascular Diseases, Beijing, ChinaDepartment of Cardiology, Beijing AnZhen Hospital, Capital Medical University, National Clinical Research Centre for Cardiovascular Diseases, Beijing, ChinaDepartment of Cardiology, Beijing AnZhen Hospital, Capital Medical University, National Clinical Research Centre for Cardiovascular Diseases, Beijing, ChinaHeart Health Research Centre, Beijing, ChinaThe George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, AustraliaDepartment of Cardiology, Beijing AnZhen Hospital, Capital Medical University, National Clinical Research Centre for Cardiovascular Diseases, Beijing, ChinaDepartment of Cardiology, Beijing AnZhen Hospital, Capital Medical University, National Clinical Research Centre for Cardiovascular Diseases, Beijing, ChinaCentre for Cardiovascular Diseases, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Henan, ChinaDepartment of Cardiology, Beijing AnZhen Hospital, Capital Medical University, National Clinical Research Centre for Cardiovascular Diseases, Beijing, ChinaDepartment of Cardiology, Beijing AnZhen Hospital, Capital Medical University, National Clinical Research Centre for Cardiovascular Diseases, Beijing, ChinaLiverpool Centre for Cardiovascular Science, Liverpool Heart and Chest Hospital, University of Liverpool, Liverpool, United KingdomDepartment of Cardiology, Beijing AnZhen Hospital, Capital Medical University, National Clinical Research Centre for Cardiovascular Diseases, Beijing, ChinaBackground: “Atrial fibrillation Better Care” (ABC) pathway has been proposed to improve the management of patients suffered from atrial fibrillation (AF). This integrated or holistic management approach comprise of three aspects, including “A” Avoid stroke or Anticoagulation; “B” Better symptom control with rate or rhythm control strategies; “C” Cardiovascular risk factor and Concomitant diseases management. We aimed to confirm the beneficial evidence of ABC pathway compliance in a Chinese AF cohort.Method and Results: From the Chinese Atrial Fibrillation registry (CAFR) dataset, a total of 19,187 non-valvular AF patients were enrolled, of which 4.365 (22.8%) were ABC pathway compliant (ABC compliance group). During a median follow-up of 4.1 ± 1.8 years, The incident rate of all-cause death in ABC compliance group and non-ABC compliance group is 2.7 and 1.1 per 100 person-year (p < 0.001), the incident rate of ischemic stroke is 1.3 and 0.8% per 100 person-year (p < 0.001), the incident rate of composite outcome, which consist of all-cause death, ischemic stroke and intracranial hemorrhage, is 3.8 and 1.9 per 100 person-year (p < 0.001). On Cox multivariable analysis, ABC pathway shows an independently association with reduction of all-cause death [hazard ratio (HR) = 0.82; 95% confidence interval (CI) = 0.70–0.95] and the composite outcome (HR 0.86, 95% CI 0.76–0.96). The increasingly components of ABC integrated care compliance is associated with lower risk of all-cause death and composite events.Conclusion: In a large cohort of Chinese AF patients, ABC pathway compliance shows an independently association with reduction of all-cause death and composite outcome of all-cause death, ischemic stroke and intracranial hemorrhage. Better compliance of ABC integrated care contributes to lower HR for adverse events.https://www.frontiersin.org/articles/10.3389/fcvm.2021.762245/fullatrial fibrillationABC pathwaymortalityintegrated carecomorbidity |
| spellingShingle | Yu-Feng Wang Chao Jiang Liu He Xin Du Xin Du Xin Du Cai-Hua Sang De-Yong Long De-Yong Long Ri-Bo Tang Jian-Zeng Dong Gregory Y. H. Lip Chang-Sheng Ma Integrated Care of Atrial Fibrillation Using the ABC (Atrial fibrillation Better Care) Pathway Improves Clinical Outcomes in Chinese Population: An Analysis From the Chinese Atrial Fibrillation Registry Frontiers in Cardiovascular Medicine atrial fibrillation ABC pathway mortality integrated care comorbidity |
| title | Integrated Care of Atrial Fibrillation Using the ABC (Atrial fibrillation Better Care) Pathway Improves Clinical Outcomes in Chinese Population: An Analysis From the Chinese Atrial Fibrillation Registry |
| title_full | Integrated Care of Atrial Fibrillation Using the ABC (Atrial fibrillation Better Care) Pathway Improves Clinical Outcomes in Chinese Population: An Analysis From the Chinese Atrial Fibrillation Registry |
| title_fullStr | Integrated Care of Atrial Fibrillation Using the ABC (Atrial fibrillation Better Care) Pathway Improves Clinical Outcomes in Chinese Population: An Analysis From the Chinese Atrial Fibrillation Registry |
| title_full_unstemmed | Integrated Care of Atrial Fibrillation Using the ABC (Atrial fibrillation Better Care) Pathway Improves Clinical Outcomes in Chinese Population: An Analysis From the Chinese Atrial Fibrillation Registry |
| title_short | Integrated Care of Atrial Fibrillation Using the ABC (Atrial fibrillation Better Care) Pathway Improves Clinical Outcomes in Chinese Population: An Analysis From the Chinese Atrial Fibrillation Registry |
| title_sort | integrated care of atrial fibrillation using the abc atrial fibrillation better care pathway improves clinical outcomes in chinese population an analysis from the chinese atrial fibrillation registry |
| topic | atrial fibrillation ABC pathway mortality integrated care comorbidity |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2021.762245/full |
| work_keys_str_mv | AT yufengwang integratedcareofatrialfibrillationusingtheabcatrialfibrillationbettercarepathwayimprovesclinicaloutcomesinchinesepopulationananalysisfromthechineseatrialfibrillationregistry AT chaojiang integratedcareofatrialfibrillationusingtheabcatrialfibrillationbettercarepathwayimprovesclinicaloutcomesinchinesepopulationananalysisfromthechineseatrialfibrillationregistry AT liuhe integratedcareofatrialfibrillationusingtheabcatrialfibrillationbettercarepathwayimprovesclinicaloutcomesinchinesepopulationananalysisfromthechineseatrialfibrillationregistry AT xindu integratedcareofatrialfibrillationusingtheabcatrialfibrillationbettercarepathwayimprovesclinicaloutcomesinchinesepopulationananalysisfromthechineseatrialfibrillationregistry AT xindu integratedcareofatrialfibrillationusingtheabcatrialfibrillationbettercarepathwayimprovesclinicaloutcomesinchinesepopulationananalysisfromthechineseatrialfibrillationregistry AT xindu integratedcareofatrialfibrillationusingtheabcatrialfibrillationbettercarepathwayimprovesclinicaloutcomesinchinesepopulationananalysisfromthechineseatrialfibrillationregistry AT caihuasang integratedcareofatrialfibrillationusingtheabcatrialfibrillationbettercarepathwayimprovesclinicaloutcomesinchinesepopulationananalysisfromthechineseatrialfibrillationregistry AT deyonglong integratedcareofatrialfibrillationusingtheabcatrialfibrillationbettercarepathwayimprovesclinicaloutcomesinchinesepopulationananalysisfromthechineseatrialfibrillationregistry AT deyonglong integratedcareofatrialfibrillationusingtheabcatrialfibrillationbettercarepathwayimprovesclinicaloutcomesinchinesepopulationananalysisfromthechineseatrialfibrillationregistry AT ribotang integratedcareofatrialfibrillationusingtheabcatrialfibrillationbettercarepathwayimprovesclinicaloutcomesinchinesepopulationananalysisfromthechineseatrialfibrillationregistry AT jianzengdong integratedcareofatrialfibrillationusingtheabcatrialfibrillationbettercarepathwayimprovesclinicaloutcomesinchinesepopulationananalysisfromthechineseatrialfibrillationregistry AT gregoryyhlip integratedcareofatrialfibrillationusingtheabcatrialfibrillationbettercarepathwayimprovesclinicaloutcomesinchinesepopulationananalysisfromthechineseatrialfibrillationregistry AT changshengma integratedcareofatrialfibrillationusingtheabcatrialfibrillationbettercarepathwayimprovesclinicaloutcomesinchinesepopulationananalysisfromthechineseatrialfibrillationregistry |