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Effects of the ABC pathway on clinical outcomes in very elderly Chinese patients with atrial fibrillation. A report from the optimal thromboprophylaxis in elderly Chinese patients with atrial fibrillation (ChiOTEAF) registry

Year: 2025

Type: article

Abstract: The current Atrial fibrillation Better Care (ABC) pathway for holistic or integrated management of AF is associated with improved clinical outcomes; however, data on the very elderly (aged ≥ 85 years) are sparse.To evaluate the impact of ABC pathway on clinical outcomes amongst very elderly AF patients over a follow-up period of 1 year.The ChiOTEAF registry is a prospective, multicenter nationwide study conducted from October 2014 to December 2018. Endpoints of interest were the composite outcome of all-cause death/any thromboembolism (TE), all-cause death, TE events, and major bleeding.The eligible cohort included 1215 individuals (mean age 88.5 ± 3.3; 33.5% female), of which 142 (11.7%) were managed accordingly to the ABC pathway. ABC compliance was independently associated with lower odds of the composite outcome (odds Ratio (OR): 0.23; 95% confidence interval (CI): 0.08-0.66) and all-cause death (OR: 0.22; 95% CI: 0.07-0.75), without a significant increase in major bleeding compared to ABC non-compliance. Health-related quality of life (QOL) was also significantly higher in the ABC compliant group compared to the non-compliant group (EQ score 0.83 ± 0.17 vs. 0.78 ± 0.20; p = 0.004). Independent predictors of ABC non-compliance were prior major bleeding, chronic kidney disease, and dementia.Our findings suggest that adherence to the ABC pathway in very elderly patients is associated with significantly improved survival and health-related QOL.

Source: Internal and Emergency Medicine

DOI: 10.1007/s11739-025-03928-0

Authors: Ameenathul Mazaya Fawzy, Agnieszka Kotalczyk, Yutao Guo, Yutang Wang, Gregory Y. H. Lip, ChiOTEAF Registry Investigators