• Monika Kozieł, Stefan Simovic, Nikola Pavlovic, Aleksander Kocijancic, Vilma Paparisto, Ljilja Music, Elina Trendafilova, Anca R Dan, Zumreta Kusljugic, Gheorghe-Andrei Dan, Lip Gregory Y H GYH Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom; Department of Ca, and Tatjana S Potpara.
• Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom; Department of Cardiology, Congenital Heart Diseases and Electrotherapy, Medical University of Silesia, Silesian Centre for Heart Diseases, Zabrze, Poland
• Pol. Arch. Med. Wewn. 2020 Mar 27; 130 (3): 187-195.

IntroductionThe Atrial fibrillation Better Care (ABC) pathway provides a useful way of simplifying decision‑making considerations in a holistic approach to atrial fibrillation management.ObjectivesTo evaluate adherence to the ABC pathway and to determine major gaps in adherence in patients in the BALKAN‑AF survey.Patients And MethodsIn this ancillary analysis, patients from the BALKAN‑AF survey were divided into the following groups: A (avoid stroke) + B (better symptom control) + C (cardiovascular and comorbidity risk management)-adherent and -nonadherent management.ResultsAmong 2712 enrolled patients, 1013 (43.8%) patients with mean (SD) age of 68.8 (10.2) years and mean CHA2DS2‑VASc score of 3.4 (1.8) had A+B+C-adherent management and 1299 (56.2%) had A+B+C-nonadherent management. Independent predictors of increased A+B+C-adherent management were: capital city (odds ratio [OR], 1.23; 95% CI, 1.03-1.46; P = 0.02), treatment by cardiologist (OR, 1.34; 95% CI, 1.08-1.66; P = 0.01), hypertension (OR, 2.2; 95% CI, 1.74-2.77; P <0.001), diabetes mellitus (OR, 1.28; 95% CI, 1.05-1.57; P = 0.01), and multimorbidity (the presence of 2 or more long‑ term conditions) (OR, 1.85; 95% CI, 1.43-2.38; P <0.001). Independent predictors of decreased A+B+C-adherent management were: age 80 years or older (OR, 0.61; 95% CI, 0.48-0.76; P <0.001) and history of bleeding (OR, 0.5; 95% CI, 0.33-0.75; P = 0.001).ConclusionsPhysicians' adherence to integrated AF management based on the ABC pathway was suboptimal. Addressing the identified clinical and system‑related factors associated with A+B+C-nonadherent management using targeted approaches is needed to optimize treatment of patients with AF in the Balkan region.

12 keywords...

hide…