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Relation of the ‘Atrial Fibrillation Better Care (ABC) Pathway’ to the Quality of Anticoagulation in Atrial Fibrillation Patients Taking Vitamin K Antagonists

The Atrial Fibrillation Better Care (ABC) pathway was proposed for a more integrated atrial fibrillation (AF) care. We investigated if adherence to the ABC pathway was associated to the quality of anticoagulation control in a cohort of AF outpatients starting vitamin K antagonists (VKAs) between Jul...

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Autores principales: Roldán, Vanessa, Martínez-Montesinos, Lorena, López-Gálvez, Raquel, García-Tomás, Lucía, Lip, Gregory Y. H., Rivera-Caravaca, José Miguel, Marín, Francisco
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8954236/
https://www.ncbi.nlm.nih.gov/pubmed/35330486
http://dx.doi.org/10.3390/jpm12030487
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author Roldán, Vanessa
Martínez-Montesinos, Lorena
López-Gálvez, Raquel
García-Tomás, Lucía
Lip, Gregory Y. H.
Rivera-Caravaca, José Miguel
Marín, Francisco
author_facet Roldán, Vanessa
Martínez-Montesinos, Lorena
López-Gálvez, Raquel
García-Tomás, Lucía
Lip, Gregory Y. H.
Rivera-Caravaca, José Miguel
Marín, Francisco
author_sort Roldán, Vanessa
collection PubMed
description The Atrial Fibrillation Better Care (ABC) pathway was proposed for a more integrated atrial fibrillation (AF) care. We investigated if adherence to the ABC pathway was associated to the quality of anticoagulation control in a cohort of AF outpatients starting vitamin K antagonists (VKAs) between July 2016 and June 2018. Patients were considered adherent to the ABC pathway if they met all of its components. The time in therapeutic range (TTR) was estimated at one year. In total, 1045 patients (51.6% female; median age 77 years; 63% ABC pathway adherent) were included. At one year, 474 (51.6%) of 919 patients with international normalized ratio (INR) data for TTR estimation had a TTR < 65%. Among ABC pathway non-adherent patients, a greater proportion had TRT < 65% (56.4% vs. 43.6%, p = 0.025), and TTR < 70% (64.9% vs. 35.1%, p = 0.033), with lower mean TTR in non-adherent patients (59.4 ± 22.3% vs. 63.9 ± 21.1%; p = 0.004). Logistic regression models demonstrated that the ABC pathway adherence in its continuous (aOR: 0.75, 95% CI 0.59–0.96) and categorical (aOR: 0.75, 95% CI 0.57–0.98) forms was independently associated with TTR ≥ 65%. In this ‘real-world’ cohort of AF patients starting VKAs, the ABC pathway adherent patients had better TTR, and more ABC criteria fulfilled increased the probability of achieving good TTR.
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spelling pubmed-89542362022-03-26 Relation of the ‘Atrial Fibrillation Better Care (ABC) Pathway’ to the Quality of Anticoagulation in Atrial Fibrillation Patients Taking Vitamin K Antagonists Roldán, Vanessa Martínez-Montesinos, Lorena López-Gálvez, Raquel García-Tomás, Lucía Lip, Gregory Y. H. Rivera-Caravaca, José Miguel Marín, Francisco J Pers Med Article The Atrial Fibrillation Better Care (ABC) pathway was proposed for a more integrated atrial fibrillation (AF) care. We investigated if adherence to the ABC pathway was associated to the quality of anticoagulation control in a cohort of AF outpatients starting vitamin K antagonists (VKAs) between July 2016 and June 2018. Patients were considered adherent to the ABC pathway if they met all of its components. The time in therapeutic range (TTR) was estimated at one year. In total, 1045 patients (51.6% female; median age 77 years; 63% ABC pathway adherent) were included. At one year, 474 (51.6%) of 919 patients with international normalized ratio (INR) data for TTR estimation had a TTR < 65%. Among ABC pathway non-adherent patients, a greater proportion had TRT < 65% (56.4% vs. 43.6%, p = 0.025), and TTR < 70% (64.9% vs. 35.1%, p = 0.033), with lower mean TTR in non-adherent patients (59.4 ± 22.3% vs. 63.9 ± 21.1%; p = 0.004). Logistic regression models demonstrated that the ABC pathway adherence in its continuous (aOR: 0.75, 95% CI 0.59–0.96) and categorical (aOR: 0.75, 95% CI 0.57–0.98) forms was independently associated with TTR ≥ 65%. In this ‘real-world’ cohort of AF patients starting VKAs, the ABC pathway adherent patients had better TTR, and more ABC criteria fulfilled increased the probability of achieving good TTR. MDPI 2022-03-17 /pmc/articles/PMC8954236/ /pubmed/35330486 http://dx.doi.org/10.3390/jpm12030487 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Roldán, Vanessa
Martínez-Montesinos, Lorena
López-Gálvez, Raquel
García-Tomás, Lucía
Lip, Gregory Y. H.
Rivera-Caravaca, José Miguel
Marín, Francisco
Relation of the ‘Atrial Fibrillation Better Care (ABC) Pathway’ to the Quality of Anticoagulation in Atrial Fibrillation Patients Taking Vitamin K Antagonists
title Relation of the ‘Atrial Fibrillation Better Care (ABC) Pathway’ to the Quality of Anticoagulation in Atrial Fibrillation Patients Taking Vitamin K Antagonists
title_full Relation of the ‘Atrial Fibrillation Better Care (ABC) Pathway’ to the Quality of Anticoagulation in Atrial Fibrillation Patients Taking Vitamin K Antagonists
title_fullStr Relation of the ‘Atrial Fibrillation Better Care (ABC) Pathway’ to the Quality of Anticoagulation in Atrial Fibrillation Patients Taking Vitamin K Antagonists
title_full_unstemmed Relation of the ‘Atrial Fibrillation Better Care (ABC) Pathway’ to the Quality of Anticoagulation in Atrial Fibrillation Patients Taking Vitamin K Antagonists
title_short Relation of the ‘Atrial Fibrillation Better Care (ABC) Pathway’ to the Quality of Anticoagulation in Atrial Fibrillation Patients Taking Vitamin K Antagonists
title_sort relation of the ‘atrial fibrillation better care (abc) pathway’ to the quality of anticoagulation in atrial fibrillation patients taking vitamin k antagonists
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8954236/
https://www.ncbi.nlm.nih.gov/pubmed/35330486
http://dx.doi.org/10.3390/jpm12030487
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