Standard versus atrial fibrillation-specific management strategy (SAFETY) to reduce recurrent admission and prolong survival: pragmatic, multicentre, randomised controlled trial

Stewart, Simon; Ball, Jocasta; Horowitz, John D.; Marwick, Thomas H.; Mahadevan, Gnanadevan; Wong, Chiew; Abhayaratna, Walter P.; Chan, Yih-Kai; Esterman, Adrian; Thompson, David R.; Scuffham, Paul Anthony; Carrington, Melinda

doi:10.1016/s0140-6736(14)61992-9

Cited by 118 publications

(105 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…W tym badaniu stwierdzono również, że zintegrowane leczenie AF było efektywne kosztowo [331]. W australijskiej RCT wykazano jednak tylko marginalny wpływ na zgony i nieplanowane hospitalizacje, gdy stosowano zintegrowaną opiekę ograniczoną do początkowego okresu leczenia, co być może podkreśla potrzebę długotrwałej integracji leczenia AF [332]. W 2 badaniach obserwacyjnych dotyczących zintegrowanego leczenia AF stwierdzono mniejszą częstość hospitalizacji [333,334], w 1 badaniu zaobserwowano mniej przypadków udaru mózgu [333], a w kolejnym nierandomizowanym badaniu wykazano trend w kierunku mniejszej częstości występowania złożonego punktu końcowego obejmującego zgony, hospitalizacje z przyczyn sercowo--naczyniowych oraz wizyty na oddziale pomocy doraźnej związane z AF [335].…”

Section: Dowody Z Badań Naukowychunclassified

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

Kirchhof

Benussi

Kotecha³

et al. 2016

Kardiol Pol

2,339

4,202

View full text Add to dashboard Cite

Section: Dowody Z Badań Naukowychunclassified

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

Kirchhof

Benussi

Kotecha³

et al. 2016

Kardiol Pol

2,339

4,202

View full text Add to dashboard Cite

“…Specific AF services, for example in the form of specialist AF clinics 89 and integrated AF services 50,90 , will have an important role in the validation and clinical evaluation of the major health modifiers of AF 91 . Such expert services will also be seminal points for the wider use of the new classification of patients with AF.…”

Section: Chronic Kidney Diseasementioning

confidence: 99%

Defining the major health modifiers causing atrial fibrillation: a roadmap to underpin personalized prevention and treatment

et al. 2015

View full text Add to dashboard Cite

Despite the important advances that have enabled better stroke prevention in atrial fibrillation (AF) and more effective maintenance of sinus rhythm over the past decades, a large unmet need to improve the prevention and treatment of AF remains. Mortality for AF remains at 3.5% per year, and death is often experienced as sudden death or as a result of heart failure 1,2 . Each year, approximately 20% of patients with AF need to be hospitalized 3,4 , and stroke occurs in 1.5% of patients with AF who are receiving anticoagulant drugs 5 . Furthermore, more than half of the patients with AF are symptomatic despite adequate anticoagulation and rate control 4,6 . In view of the projected increase in the incidence and prevalence of AF 7-9 , as well as the substantial burden of death and dis ability that is still associated with this condition 10 , the status quo is unacceptable.Current management of patients with AF comprises treatment of the accompanying cardiovascular conditions, oral anticoagulation, rate control -with medications that slow atrioventricular nodal recovery or, rarely, with atrioventricular nodal ablation -and rhythm-control therapy with antiarrhythmic drugs, electrical cardioversion, catheter ablation or, at times, AF surgery 11,12 . Unfortunately, most of these current approaches are disconnected from our understanding of the major mechanisms that cause AF 1,13,14 1,2,7,19,20 Abstract | Despite remarkable advances in antiarrhythmic drugs, ablation procedures, and stroke-prevention strategies, atrial fibrillation (AF) remains an important cause of death and disability in middle-aged and elderly individuals. Unstructured management of patients with AF sharply contrasts with our detailed, although incomplete, knowledge of the mechanisms that cause AF and its complications. Altered calcium homeostasis, atrial fibrosis and ageing, ion-channel dysfunction, autonomic imbalance, fat-cell infiltration, and oxidative stress, in addition to a susceptible genetic background, contribute to the promotion, maintenance, and progression of AF. However, clinical management of patients with AF is currently guided by stroke risk parameters, AF pattern, and symptoms. In response to this apparent disconnect between the known pathophysiology of AF and clinical management, we propose a roadmap to develop a set of clinical markers that reflect the major causes of AF in patients. Thereby, the insights into the mechanisms causing AF will be transformed into a format that can underpin future personalized strategies to prevent and treat AF, ultimately informing better patient care.230 | APRIL 2016 | VOLUME 13 www.nature.com/nrcardio CONSENSUS STATEMENT © 2 0 1 6 M a c m i l l a n P u b l i s h e r s L i m i t e d . A l l r i g h t s r e s e r v e d .

show abstract

“…7 Likewise, disease-specific management programmes demonstrate favourable outcomes. 8 Key aspects of these models of care include care that is provided following a multidisciplinary approach, where specialists in AF management work closely together, but also where patients and caregivers have time to discuss their condition, symptoms, treatment regimens and lifestyle behaviour with healthcare providers in a less time-poor setting. This structured, integrated approach to care is adopted by the recently launched 2016 European Society of Cardiology guidelines on the management of AF as the recommended AF management approach.…”

Section: Need For a Paradigm Shift In Anticoagulant Decision-makingmentioning

confidence: 99%

Partnering with patients in shared decision-making for stroke prevention in atrial fibrillation

Ferguson

Hendriks

2016

European Journal of Cardiovascular Nursing

View full text Add to dashboard Cite

Standard versus atrial fibrillation-specific management strategy (SAFETY) to reduce recurrent admission and prolong survival: pragmatic, multicentre, randomised controlled trial

Cited by 118 publications

References 31 publications

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

Defining the major health modifiers causing atrial fibrillation: a roadmap to underpin personalized prevention and treatment

Partnering with patients in shared decision-making for stroke prevention in atrial fibrillation

Contact Info

Product

Resources

About