Rungroj Krittayaphong, Ply Chichareon, Komsing Methavigul, Sukrit Treewaree, Gregory Y H Lip
{"title":"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。","authors":"Rungroj Krittayaphong, Ply Chichareon, Komsing Methavigul, Sukrit Treewaree, Gregory Y H Lip","doi":"10.1093/ehjqcco/qcae039","DOIUrl":null,"url":null,"abstract":"<p><strong>Aims: </strong>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.</p><p><strong>Methods and results: </strong>This is a prospective multicenter AF registry. Patients with non-valvular AF were enrolled and followed-up for 3 years. Baseline and follow-up compliance to the ABC pathway was assessed. The main outcomes were all-cause death, ischaemic stroke/systemic embolism, major bleeding, and heart failure. There studied 3096 patients (mean age 67.6 ± 11.1 years, 41.8% female). Patients were categorized into four 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 1-4 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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":11869,"journal":{"name":"European Heart Journal - Quality of Care and Clinical Outcomes","volume":" ","pages":"239-248"},"PeriodicalIF":4.8000,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Relation of changes in ABC pathway compliance status to clinical outcomes in patients with atrial fibrillation: a report from the COOL-AF registry.\",\"authors\":\"Rungroj Krittayaphong, Ply Chichareon, Komsing Methavigul, Sukrit Treewaree, Gregory Y H Lip\",\"doi\":\"10.1093/ehjqcco/qcae039\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Aims: </strong>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.</p><p><strong>Methods and results: </strong>This is a prospective multicenter AF registry. Patients with non-valvular AF were enrolled and followed-up for 3 years. Baseline and follow-up compliance to the ABC pathway was assessed. The main outcomes were all-cause death, ischaemic stroke/systemic embolism, major bleeding, and heart failure. There studied 3096 patients (mean age 67.6 ± 11.1 years, 41.8% female). Patients were categorized into four 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 1-4 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.</p><p><strong>Conclusion: </strong>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.</p>\",\"PeriodicalId\":11869,\"journal\":{\"name\":\"European Heart Journal - Quality of Care and Clinical Outcomes\",\"volume\":\" \",\"pages\":\"239-248\"},\"PeriodicalIF\":4.8000,\"publicationDate\":\"2025-05-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European Heart Journal - Quality of Care and Clinical Outcomes\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1093/ehjqcco/qcae039\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Heart Journal - Quality of Care and Clinical Outcomes","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/ehjqcco/qcae039","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Relation of changes in ABC pathway compliance status to clinical outcomes in patients with atrial fibrillation: a report from the COOL-AF registry.
Aims: 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 and results: This is a prospective multicenter AF registry. Patients with non-valvular AF were enrolled and followed-up for 3 years. Baseline and follow-up compliance to the ABC pathway was assessed. The main outcomes were all-cause death, ischaemic stroke/systemic embolism, major bleeding, and heart failure. There studied 3096 patients (mean age 67.6 ± 11.1 years, 41.8% female). Patients were categorized into four 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 1-4 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.
期刊介绍:
European Heart Journal - Quality of Care & Clinical Outcomes is an English language, peer-reviewed journal dedicated to publishing cardiovascular outcomes research. It serves as an official journal of the European Society of Cardiology and maintains a close alliance with the European Heart Health Institute. The journal disseminates original research and topical reviews contributed by health scientists globally, with a focus on the quality of care and its impact on cardiovascular outcomes at the hospital, national, and international levels. It provides a platform for presenting the most outstanding cardiovascular outcomes research to influence cardiovascular public health policy on a global scale. Additionally, the journal aims to motivate young investigators and foster the growth of the outcomes research community.