ABC adherence and impact of optimal medical therapy in heart failure patients with atrial fibrillation

Abstract Background Heart failure (HF) has close association with atrial fibrillation (AF). The ESC guideline recommended Atrial Better care (ABC) pathway aims to reduce major cardiovascular adverse outcomes an integrated approach. Optimal medical treatment (OMT) represents the cornerstone in HF management. Purpose To investigate variables affecting OMT and its impact, conjunction ABC adherence (vs non-adherence, ie.no ABC), a large contemporary cohort of European AF patients enrolled ESC-EHRA EORP-AF General Long-Term Registry. Methods was defined as Angiotensin-converting-enzyme inhibitors (ACE-i)/ Angiotensin receptor blockers (ARBs) Beta-Blockers and/or Mineralocorticoid antagonists (MRAs), compared non-OMT (“no OMT”). A logistic regression analysis explored factors associated adherence. We identified three patient groups: (i) no OMT/no ABC; (ii) (iii) OMT/ABC. Primary outcome composite all-cause death cardiac events (MACE). Results Among original 11096 enrolled, 9857 (88.8%) were included this analysis. these, 3819 (38.7%) had HF. Compared non patients, those older, more likely female, comorbidities higher thromboembolic risk. prevalence 2228/3819 (58.3%), while 23.3%. On multivariable regression, increasing age, BMI frailty index adherence, male sex, anemia, renal disease EHRA II–IV inversely According groups, rates progressively decreased (HF 26.4%; 24%, OMT/ABC 19%; p<0.001). Kaplan Meier curve showed lower cumulative risk for across groups lowest among (Log-rank: p=0.002) [Figure 1]. Adjusted Cox that when group, there ABC: HR 0.81 [95% CI, 0.64–1.02]; OMT/ABC: 0.68 0.5–0.92]). Conclusions After two years follow-up, HF, suboptimal, being influenced by several clinical factors, determining low pathway. alone non-significant reduction events. Conversely managed context best outcomes. Funding Acknowledgement Type funding sources: Other. Main source(s): Since start EORP, following companies have supported programme: Abbott Vascular Int. (2011–2021), Amgen Cardiovascular (2009–2018), AstraZeneca (2014–2021), Bayer Boehringer Ingelheim (2009–2019), Boston Scientific (2009–2012), Bristol Myers Squibb Pfizer Alliance (2011–2016), Daiichi Sankyo Europe GmbH Eli Lilly Company (2011–2017), Edwards (2016–2019), Gedeon Richter Plc. (2014–2017), Menarini Op. MSD-Merck & Co. (2011–2014), Novartis Pharma AG (2014–2020), ResMed (2014–2016), Sanofi (2009–2011), SERVIER (2010–2021), Vifor (2019–2022). - I agree information can be anonymised then used statistical purposes only