Introduction Atrial fibrillation (AF) and diabetes mellitus (DM) constitute a heavy burden on healthcare expenditure due to their negative impact on clinical outcomes in patients. DM is highly prevalent in the Middle East. The Atrial fibrillation Better Care (ABC) pathway provides a simple step-by-step strategy with an integrated, holistic approach to AF management: A, Avoid stroke (Anticoagulation); B, Better symptom management; C, Cardiovascular and comorbidity risk management. Aim Evaluation of the AF treatment compliance to ABC pathway regimen in patients with DM based on a large real-world registry from the Middle East region. We assessed the impact of ABC-pathway compliance on all-cause mortality and the composite outcome of stroke or systemic embolism, all-cause death and cardiovascular hospitalizations. Methods From 2043 patients in the Gulf SAFE registry, 603 patients with DM were included in an analysis of compliance with components of the ABC pathway: A, oral anticoagulation (OAC) use in patients with CHA2DS2-VASc score ≥1 (≥2 in females); B, AF symptoms according to the European Heart Rhythm Association (EHRA) score; C, Optimized management of cardiovascular comorbidities e.g. blood pressure control, statins for vascular disease, etc. Results From 606 patients, 86 (14.3%) patients were treated in compliance with the ABC pathway. During 1-year follow-up, 207 composite outcome events and 87 deaths occurred. Mortality was significantly lower in the ABC-adherent group vs non-ABC compliant (5.8% vs 15.9%, p=0.0014, respectively) (Figure). On multivariate analysis, ABC-adherent management was associated with a lower risk of all-cause death and the composite outcome after 6 months (OR 0.18; 95% CI, 0.42–0.75 and OR 0.54; 95% Cl, 0.30–1.00, respectively) and at 1 year (OR 0.30; 95% Cl,0.11–0.76 and OR 0.57; 95% Cl, 0.33–0.97, respectively) vs the non-ABC group (Table). Conclusions Integrated AF care, according to ABC pathway, was independently associated with a lower risk of all-cause death and the composite outcome, in DM patients with AF. This highlights the importance of a comprehensive and holistic approach to AF management. Events rates and outcomes odds ratio Funding Acknowledgement Type of funding source: None
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.