Expert review of cardiovascular therapy · 2026
Compliance with the ABC pathway for integrated care of patients with atrial fibrillation in Brazil: a retrospective cohort study.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Santos Itamar S, Goulart Alessandra C, Olmos Rodrigo D, Varella Ana C, Quintino Carla R, Gebara Otávio C E, Lopes Ana T A, Lopes Flavia P P L, Gooden Tiffany E, Thomas G Neil, Lip Gregory Y H, Lotufo Paulo A, Benseñor Isabela M, on behalf of the NIHR Global Health Research Group on Atrial Fibrillation Management
Аннотация
BACKGROUND: Information about integrated care for patients with atrial fibrillation (AF) in low- and middle-income countries is scarce.
METHODS: We analyzed multicentre data from 699 patients with AF treated in São Paulo, Brazil. ABC compliance was defined as (1) adequate anticoagulation ('A' component); (2) controlled AF symptoms ('B' component); and (3) comorbidities treatment ('C' component). We built logistic regression models to identify characteristics associated with ABC compliance.
RESULTS: Mean age was 69.4 ± 14.4 years (45.8% women; 57.4% from private healthcare). Compliance with ABC pathway, and with the 'A,' 'B' and 'C' components occurred in 20.9%, 42.3%, 81.7% and 50.1% of the participants, respectively. Lack of ABC compliance was associated with female sex (adjusted odds ratio [aOR]: 1.66; p = 0.015), intermediate (aOR: 3.37; p < 0.001) and high (aOR: 9.17; p < 0.001) bleeding risk. Patients with AF treated in public units had worse performance for the 'A' component (aOR: 2.50; p < 0.001) and better performance for the 'C' component (aOR: 0.49; p < 0.001) compared to those using private healthcare.
CONCLUSIONS: Compliance with the ABC pathway in São Paulo, Brazil was low. Lack of ABC compliance was more common in women and individuals with high bleeding risk. We found a mixed pattern of ABC compliance in public and private units.
METHODS: We analyzed multicentre data from 699 patients with AF treated in São Paulo, Brazil. ABC compliance was defined as (1) adequate anticoagulation ('A' component); (2) controlled AF symptoms ('B' component); and (3) comorbidities treatment ('C' component). We built logistic regression models to identify characteristics associated with ABC compliance.
RESULTS: Mean age was 69.4 ± 14.4 years (45.8% women; 57.4% from private healthcare). Compliance with ABC pathway, and with the 'A,' 'B' and 'C' components occurred in 20.9%, 42.3%, 81.7% and 50.1% of the participants, respectively. Lack of ABC compliance was associated with female sex (adjusted odds ratio [aOR]: 1.66; p = 0.015), intermediate (aOR: 3.37; p < 0.001) and high (aOR: 9.17; p < 0.001) bleeding risk. Patients with AF treated in public units had worse performance for the 'A' component (aOR: 2.50; p < 0.001) and better performance for the 'C' component (aOR: 0.49; p < 0.001) compared to those using private healthcare.
CONCLUSIONS: Compliance with the ABC pathway in São Paulo, Brazil was low. Lack of ABC compliance was more common in women and individuals with high bleeding risk. We found a mixed pattern of ABC compliance in public and private units.