Relation of changes in ABC pathway compliance status to clinical outcomes in patients with atrial fibrillation: a report from the COOL-AF registry
Issued Date
2025-04-01
Resource Type
ISSN
20585225
eISSN
20581742
Scopus ID
2-s2.0-105004214290
Pubmed ID
38794883
Journal Title
European Heart Journal - Quality of Care and Clinical Outcomes
Volume
11
Issue
3
Start Page
239
End Page
248
Rights Holder(s)
SCOPUS
Bibliographic Citation
European Heart Journal - Quality of Care and Clinical Outcomes Vol.11 No.3 (2025) , 239-248
Suggested Citation
Krittayaphong R., Chichareon P., Methavigul K., Treewaree S., Lip G.Y.H. Relation of changes in ABC pathway compliance status to clinical outcomes in patients with atrial fibrillation: a report from the COOL-AF registry. European Heart Journal - Quality of Care and Clinical Outcomes Vol.11 No.3 (2025) , 239-248. 248. doi:10.1093/ehjqcco/qcae039 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/110045
Title
Relation of changes in ABC pathway compliance status to clinical outcomes in patients with atrial fibrillation: a report from the COOL-AF registry
Corresponding Author(s)
Other Contributor(s)
Abstract
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.