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

Marco Vitolo; Marco Proietti; Vincenzo L Malavasi; Niccolo' Bonini; Giulio Francesco Romiti; Jacopo F Imberti; Laurent Fauchier; Francisco Marin; Michael Nabauer; Tatjana S Potpara; Gheorghe-Andrei Dan; Zbigniew Kalarus; Aldo Pietro Maggioni; Deirdre A Lane; Gregory Y H Lip; Giuseppe Boriani; ESC-EHRA EORP-AF Long-Term General Registry Investigators; Ömer Erküner; Harry Crijns

doi:10.1016/j.ejim.2022.08.004

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

Marco Vitolo, Marco Proietti, Vincenzo L Malavasi, Niccolo' Bonini, Giulio Francesco Romiti, Jacopo F Imberti, Laurent Fauchier, Francisco Marin, Michael Nabauer, Tatjana S Potpara, Gheorghe-Andrei Dan, Zbigniew Kalarus, Aldo Pietro Maggioni, Deirdre A Lane, Gregory Y H Lip, Giuseppe Boriani^*, ESC-EHRA EORP-AF Long-Term General Registry Investigators, Ömer Erküner, Harry Crijns

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

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.

Original language	English
Pages (from-to)	54-62
Number of pages	9
Journal	European journal of internal medicine
Volume	105
DOIs	https://doi.org/10.1016/j.ejim.2022.08.004
Publication status	Published - Nov 2022

Keywords

Female
Humans
Aged
Atrial Fibrillation/epidemiology
Stroke/epidemiology
Risk Factors
Registries
Hemorrhage/chemically induced
Anticoagulants/adverse effects
Neoplasms/complications

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10.1016/j.ejim.2022.08.004

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Vitolo, M., Proietti, M., Malavasi, V. L., Bonini, N., Romiti, G. F., Imberti, J. F., Fauchier, L., Marin, F., Nabauer, M., Potpara, T. S., Dan, G.-A., Kalarus, Z., Maggioni, A. P., Lane, D. A., Lip, G. Y. H., Boriani, G., ESC-EHRA EORP-AF Long-Term General Registry Investigators, Erküner, Ö., & Crijns, H. (2022). 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. European journal of internal medicine, 105, 54-62. https://doi.org/10.1016/j.ejim.2022.08.004

Vitolo, Marco ; Proietti, Marco ; Malavasi, Vincenzo L et al. / 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. In: European journal of internal medicine. 2022 ; Vol. 105. pp. 54-62.

@article{d0adc15e00e947ce83392b58e70a6e1e,

title = "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",

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.",

keywords = "Female, Humans, Aged, Atrial Fibrillation/epidemiology, Stroke/epidemiology, Risk Factors, Registries, Hemorrhage/chemically induced, Anticoagulants/adverse effects, Neoplasms/complications",

author = "Marco Vitolo and Marco Proietti and Malavasi, {Vincenzo L} and Niccolo' Bonini and Romiti, {Giulio Francesco} and Imberti, {Jacopo F} and Laurent Fauchier and Francisco Marin and Michael Nabauer and Potpara, {Tatjana S} and Gheorghe-Andrei Dan and Zbigniew Kalarus and Maggioni, {Aldo Pietro} and Lane, {Deirdre A} and Lip, {Gregory Y H} and Giuseppe Boriani and {ESC-EHRA EORP-AF Long-Term General Registry Investigators} and {\"O}mer Erk{\"u}ner and Harry Crijns",

note = "Copyright {\textcopyright} 2022. Published by Elsevier B.V.",

year = "2022",

month = nov,

doi = "10.1016/j.ejim.2022.08.004",

language = "English",

volume = "105",

pages = "54--62",

journal = "European journal of internal medicine",

issn = "0953-6205",

publisher = "Elsevier Science",

}

Vitolo, M, Proietti, M, Malavasi, VL, Bonini, N, Romiti, GF, Imberti, JF, Fauchier, L, Marin, F, Nabauer, M, Potpara, TS, Dan, G-A, Kalarus, Z, Maggioni, AP, Lane, DA, Lip, GYH, Boriani, G, ESC-EHRA EORP-AF Long-Term General Registry Investigators, Erküner, Ö & Crijns, H 2022, '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', European journal of internal medicine, vol. 105, pp. 54-62. https://doi.org/10.1016/j.ejim.2022.08.004

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. / Vitolo, Marco; Proietti, Marco; Malavasi, Vincenzo L et al.
In: European journal of internal medicine, Vol. 105, 11.2022, p. 54-62.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Adherence to the "Atrial fibrillation Better Care" (ABC) pathway in patients with atrial fibrillation and cancer

T2 - A report from the ESC-EHRA EURObservational Research Programme in atrial fibrillation (EORP-AF) General Long-Term Registry

AU - Vitolo, Marco

AU - Proietti, Marco

AU - Malavasi, Vincenzo L

AU - Bonini, Niccolo'

AU - Romiti, Giulio Francesco

AU - Imberti, Jacopo F

AU - Fauchier, Laurent

AU - Marin, Francisco

AU - Nabauer, Michael

AU - Potpara, Tatjana S

AU - Dan, Gheorghe-Andrei

AU - Kalarus, Zbigniew

AU - Maggioni, Aldo Pietro

AU - Lane, Deirdre A

AU - Lip, Gregory Y H

AU - Boriani, Giuseppe

AU - ESC-EHRA EORP-AF Long-Term General Registry Investigators

AU - Erküner, Ömer

AU - Crijns, Harry

PY - 2022/11

Y1 - 2022/11

N2 - 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.

AB - 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.

KW - Female

KW - Humans

KW - Aged

KW - Atrial Fibrillation/epidemiology

KW - Stroke/epidemiology

KW - Risk Factors

KW - Registries

KW - Hemorrhage/chemically induced

KW - Anticoagulants/adverse effects

KW - Neoplasms/complications

U2 - 10.1016/j.ejim.2022.08.004

DO - 10.1016/j.ejim.2022.08.004

M3 - Article

C2 - 36028394

SN - 0953-6205

VL - 105

SP - 54

EP - 62

JO - European journal of internal medicine

JF - European journal of internal medicine

ER -

Vitolo M, Proietti M, Malavasi VL, Bonini N, Romiti GF, Imberti JF et al. 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. European journal of internal medicine. 2022 Nov;105:54-62. doi: 10.1016/j.ejim.2022.08.004