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Adherence to the “Atrial Fibrillation Better Care” (Abc) Pathway in Patients With Atrial Fibrillation and Cancer: A Report From the Esc-Ehra Eurobservational Research Programme in Atrial Fibrillation (Eorp-Af) General Long-Term Registry Publisher Pubmed



Vitolo M1, 2, 3 ; Proietti M2, 4, 5 ; Malavasi VL1 ; Bonini N1, 2 ; Romiti GF2, 6 ; Imberti JF1, 2, 3 ; Fauchier L7 ; Marin F8 ; Nabauer M9 ; Potpara TS10, 11 ; Dan GA12, 42 ; Kalarus Z13 ; Maggioni AP14 ; Lane DA2, 15 Show All Authors
Authors
  1. Vitolo M1, 2, 3
  2. Proietti M2, 4, 5
  3. Malavasi VL1
  4. Bonini N1, 2
  5. Romiti GF2, 6
  6. Imberti JF1, 2, 3
  7. Fauchier L7
  8. Marin F8
  9. Nabauer M9
  10. Potpara TS10, 11
  11. Dan GA12, 42
  12. Kalarus Z13
  13. Maggioni AP14
  14. Lane DA2, 15
  15. Lip GYH2, 15, 45
  16. Boriani G1
  17. Marin F8
  18. Goda A16
  19. Mairesse G17
  20. Shalganov T18
  21. Antoniades L19
  22. Taborsky M20
  23. Riahi S21
  24. Muda P22
  25. Bolao IG23
  26. Piot O24
  27. Etsadashvili K26
  28. Simantirakis EN27
  29. Haim M28
  30. Azhari A29
  31. Najafian J29
  32. Santini M30
  33. Mirrakhimov E31
  34. Kulzida K32
  35. Erglis A33
  36. Poposka L34
  37. Burg MR35
  38. Crijns H36
  39. Erkuner O36
  40. Atar D37
  41. Lenarczyk R38
  42. Oliveira MM39
  43. Shah D40
  44. Serdechnaya E41
  45. Diker E44
  46. Lane D45

Source: European Journal of Internal Medicine Published:2022


Abstract

Background: Implementation of the Atrial fibrillation Better Care (ABC) pathway is recommended by guidelines on atrial fibrillation (AF), but the impact of adherence to ABC pathway in patients with cancer is unknown. Objectives: To investigate the adherence to ABC pathway and its impact on adverse outcomes in AF patients with cancer. Methods: Patients enrolled in the EORP-AF General Long-Term Registry were analyzed according to (i) No Cancer; and (ii) Prior or active cancer and stratified in relation to adherence to the ABC pathway. The composite Net Clinical Outcome (NCO) of all-cause death, major adverse cardiovascular events and major bleeding was the primary endpoint. Results: Among 6550 patients (median age 69 years, females 40.1%), 6005 (91.7%) had no cancer, while 545 (8.3%) had a diagnosis of active or prior cancer at baseline, with the proportions of full adherence to ABC pathway of 30.6% and 25.7%, respectively. Adherence to the ABC pathway was associated with a significantly lower occurrence of the primary outcome vs. non-adherence, both in ‘no cancer’ and ‘cancer’ patients [adjusted Hazard Ratio (aHR) 0.78, 95% confidence interval (CI): 0.66–0.92 and aHR 0.59, 95% CI 0.37–0.96, respectively]. Adherence to a higher number of ABC criteria was associated with a lower risk of the primary outcome, being lowest when 3 ABC criteria were fulfilled (no cancer: aHR 0.54, 95%CI: 0.36–0.81; with cancer: aHR 0.32, 95% CI 0.13–0.78). Conclusion: In AF patients with cancer enrolled in the EORP-AF General Long-Term Registry, adherence to ABC pathway was sub-optimal. Full adherence to ABC-pathway was associated with a lower risk of adverse events © 2022