{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T16:53:50Z","timestamp":1788886430700,"version":"build-2803163510"},"reference-count":28,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T00:00:00Z","timestamp":1783641600000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To assess the impact of continuity of care (COC)\u2014care provided by the same primary care physician (PCP)\u2014on outcomes in patients with atrial fibrillation (AF).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study including all patients with AF referred by PCPs (n = 17 889) between January 2010 and December 2023 in the Santiago de Compostela healthcare area (Spain). COC was categorized as \u2018PCP stability\u2019 (care by the assigned PCP) or \u2018interrupted COC\u2019 (care by multiple rotating PCPs). The association between COC and outcomes (hospitalization, mortality, stroke, and haemorrhage) was estimated using Cox regression and Fine\u2013Gray competing risk models, adjusted for potential confounders. Patients with PCP stability had a significantly lower annual referral rate (1.5 vs. 1.8, P &amp;lt; 0.001) and a higher rate of adequate oral anticoagulation (OAC) indication according to the CHA2DS2-VASc score (79.5% vs. 69.1%, P &amp;lt; 0.001). COC was independently associated with reduced all-cause mortality (hazard ratio; 95% confidence interval [CI]: 0.79; 0.69\u20130.91), a benefit that remained robust after sensitivity analyses. No significant differences were observed in stroke or haemorrhagic complications; however, competing risk analysis suggests that the higher mortality rate in the interrupted COC group likely precluded the observation of non-fatal events in this high-risk subset.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Longitudinal COC in primary care is associated with improved clinical management, including better OAC indication, and a significant reduction in all-cause mortality among patients with AF. The survival benefit of seeing the same physician appears to extend beyond anticoagulation optimization, highlighting the pleiotropic value of the patient\u2013physician relationship.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjqcco\/qcag108","type":"journal-article","created":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T11:22:12Z","timestamp":1783336932000},"source":"Crossref","is-referenced-by-count":1,"title":["Impact of primary care physician continuity on survival in patients with atrial fibrillation: a retrospective cohort study"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4486-2820","authenticated-orcid":false,"given":"Sergio","family":"Cinza-Sanjurjo","sequence":"first","affiliation":[{"name":"CS Concepci\u00f3n Arenal, \u00c1rea Sanitaria Integrada Santiago de Compostela , R\u00faa de Santiago Le\u00f3n de Caracas, 12, Santiago de Compostela PC 15701, A Coru\u00f1a ,","place":["Spain"]},{"name":"CARDIOCHUS group, Instituto de Investigaci\u00f3n Sanitaria de Santiago de Compostela (IDIS) , Choupana s\/n, Santiago de Compostela PC 15706, A Coru\u00f1a ,","place":["Spain"]},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red-Enfermedades Cardiovasculares (CIBERCV) , Av. Monforte de Lemos, 3-5. Pabell\u00f3n 11, Madrid Planta 0 28029 ,","place":["Spain"]},{"name":"Medicine Department, Santiago de Compostela University , SanFrancisco Street, Santiago de Compostela PC 15701 ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pilar","family":"Maz\u00f3n-Ramos","sequence":"additional","affiliation":[{"name":"CARDIOCHUS group, Instituto de Investigaci\u00f3n Sanitaria de Santiago de Compostela (IDIS) , Choupana s\/n, Santiago de Compostela PC 15706, A Coru\u00f1a ,","place":["Spain"]},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red-Enfermedades Cardiovasculares (CIBERCV) , Av. Monforte de Lemos, 3-5. Pabell\u00f3n 11, Madrid Planta 0 28029 ,","place":["Spain"]},{"name":"Medicine Department, Santiago de Compostela University , SanFrancisco Street, Santiago de Compostela PC 15701 ,","place":["Spain"]},{"name":"Servicio de Cardiolog\u00eda, Complejo Hospitalario Universitario de Santiago de Compostela. Choupana s\/n, Santiago de Compostela PC 15706, A Coru\u00f1a ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Rey-Aldana","sequence":"additional","affiliation":[{"name":"CARDIOCHUS group, Instituto de Investigaci\u00f3n Sanitaria de Santiago de Compostela (IDIS) , Choupana s\/n, Santiago de Compostela PC 15706, A Coru\u00f1a ,","place":["Spain"]},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red-Enfermedades Cardiovasculares (CIBERCV) , Av. Monforte de Lemos, 3-5. Pabell\u00f3n 11, Madrid Planta 0 28029 ,","place":["Spain"]},{"name":"Medicine Department, Santiago de Compostela University , SanFrancisco Street, Santiago de Compostela PC 15701 ,","place":["Spain"]},{"name":"CS A Estrada, \u00c1rea Sanitaria Integrada Santiago de Compostela , Av Benito Vigo 110, Pontevedra PC 36680 ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7703-7683","authenticated-orcid":false,"given":"Manuel","family":"Portela-Romero","sequence":"additional","affiliation":[{"name":"CS Concepci\u00f3n Arenal, \u00c1rea Sanitaria Integrada Santiago de Compostela , R\u00faa de Santiago Le\u00f3n de Caracas, 12, Santiago de Compostela PC 15701, A Coru\u00f1a ,","place":["Spain"]},{"name":"CARDIOCHUS group, Instituto de Investigaci\u00f3n Sanitaria de Santiago de Compostela (IDIS) , Choupana s\/n, Santiago de Compostela PC 15706, A Coru\u00f1a ,","place":["Spain"]},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red-Enfermedades Cardiovasculares (CIBERCV) , Av. Monforte de Lemos, 3-5. Pabell\u00f3n 11, Madrid Planta 0 28029 ,","place":["Spain"]},{"name":"Medicine Department, Santiago de Compostela University , SanFrancisco Street, Santiago de Compostela PC 15701 ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moises","family":"Rodriguez-Ma\u00f1ero","sequence":"additional","affiliation":[{"name":"CARDIOCHUS group, Instituto de Investigaci\u00f3n Sanitaria de Santiago de Compostela (IDIS) , Choupana s\/n, Santiago de Compostela PC 15706, A Coru\u00f1a ,","place":["Spain"]},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red-Enfermedades Cardiovasculares (CIBERCV) , Av. Monforte de Lemos, 3-5. Pabell\u00f3n 11, Madrid Planta 0 28029 ,","place":["Spain"]},{"name":"Medicine Department, Santiago de Compostela University , SanFrancisco Street, Santiago de Compostela PC 15701 ,","place":["Spain"]},{"name":"Servicio de Cardiolog\u00eda, Complejo Hospitalario Universitario de Santiago de Compostela. Choupana s\/n, Santiago de Compostela PC 15706, A Coru\u00f1a ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agust\u00edn","family":"P\u00eda-Morandeira","sequence":"additional","affiliation":[{"name":"CS Noia, \u00c1rea Sanitaria Integrada Santiago de Compostela , R\u00faa Rep\u00fablica Argentina, s\/n,, A Coru\u00f1a 15200 Noia ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro","family":"Rigueiro-Veloso","sequence":"additional","affiliation":[{"name":"CARDIOCHUS group, Instituto de Investigaci\u00f3n Sanitaria de Santiago de Compostela (IDIS) , Choupana s\/n, Santiago de Compostela PC 15706, A Coru\u00f1a ,","place":["Spain"]},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red-Enfermedades Cardiovasculares (CIBERCV) , Av. Monforte de Lemos, 3-5. Pabell\u00f3n 11, Madrid Planta 0 28029 ,","place":["Spain"]},{"name":"Medicine Department, Santiago de Compostela University , SanFrancisco Street, Santiago de Compostela PC 15701 ,","place":["Spain"]},{"name":"Servicio de Cardiolog\u00eda, Complejo Hospitalario Universitario de Santiago de Compostela. Choupana s\/n, Santiago de Compostela PC 15706, A Coru\u00f1a ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesus","family":"Martinon-Martinez","sequence":"additional","affiliation":[{"name":"CARDIOCHUS group, Instituto de Investigaci\u00f3n Sanitaria de Santiago de Compostela (IDIS) , Choupana s\/n, Santiago de Compostela PC 15706, A Coru\u00f1a ,","place":["Spain"]},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red-Enfermedades Cardiovasculares (CIBERCV) , Av. Monforte de Lemos, 3-5. Pabell\u00f3n 11, Madrid Planta 0 28029 ,","place":["Spain"]},{"name":"Medicine Department, Santiago de Compostela University , SanFrancisco Street, Santiago de Compostela PC 15701 ,","place":["Spain"]},{"name":"Servicio de Cardiolog\u00eda, Complejo Hospitalario Universitario de Santiago de Compostela. Choupana s\/n, Santiago de Compostela PC 15706, A Coru\u00f1a ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Ram\u00f3n","family":"Gonz\u00e1lez-Juanatey","sequence":"additional","affiliation":[{"name":"CARDIOCHUS group, Instituto de Investigaci\u00f3n Sanitaria de Santiago de Compostela (IDIS) , Choupana s\/n, Santiago de Compostela PC 15706, A Coru\u00f1a ,","place":["Spain"]},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red-Enfermedades Cardiovasculares (CIBERCV) , Av. Monforte de Lemos, 3-5. Pabell\u00f3n 11, Madrid Planta 0 28029 ,","place":["Spain"]},{"name":"Medicine Department, Santiago de Compostela University , SanFrancisco Street, Santiago de Compostela PC 15701 ,","place":["Spain"]},{"name":"Servicio de Cardiolog\u00eda, Complejo Hospitalario Universitario de Santiago de Compostela. Choupana s\/n, Santiago de Compostela PC 15706, A Coru\u00f1a ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,7,10]]},"reference":[{"key":"2026071807411438500_qcag108-B1","doi-asserted-by":"crossref","first-page":"3314","DOI":"10.1093\/eurheartj\/ehae176","article-title":"2024 ESC Guidelines for the management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS)","volume":"45","author":"Van Gelder","year":"2024","journal-title":"Eur Heart J"},{"key":"2026071807411438500_qcag108-B2","doi-asserted-by":"crossref","DOI":"10.1111\/ijcp.13625","article-title":"Non-vitamin K antagonist oral anticoagulant (NOAC) use and dosing in Canadian practice: insights from the optimising pharmacotherapy in the management approach to lowering risk in atrial fibrillation (OPTIMAL AF) programme","volume":"74","author":"Leblanc","year":"2020","journal-title":"Int J Clin Pract"},{"key":"2026071807411438500_qcag108-B3","doi-asserted-by":"crossref","first-page":"1364","DOI":"10.1001\/jamacardio.2021.3702","article-title":"Temporal association between episodes of atrial fibrillation and risk of ischemic stroke","volume":"6","author":"Singer","year":"2021","journal-title":"JAMA Cardiol"},{"key":"2026071807411438500_qcag108-B4","doi-asserted-by":"crossref","first-page":"1305","DOI":"10.1056\/NEJMoa2019422","article-title":"Early rhythm-control therapy in patients with atrial fibrillation","volume":"383","author":"Kirchhof","year":"2020","journal-title":"N Engl J Med"},{"key":"2026071807411438500_qcag108-B5","doi-asserted-by":"crossref","DOI":"10.1016\/j.ijcard.2024.132947","article-title":"Gender-specific effects of delay in cardiology consultation following primary care physician referral in atrial fibrillation patients: impact on one-year outcomes","volume":"422","author":"Otero-Garc\u00eda","year":"2025","journal-title":"Int J Cardiol"},{"key":"2026071807411438500_qcag108-B6","doi-asserted-by":"crossref","DOI":"10.1016\/j.eclinm.2022.101757","article-title":"Adherence to the Atrial Fibrillation Better Care (ABC) pathway and the risk of major outcomes in patients with atrial fibrillation: a post-hoc analysis from the prospective GLORIA-AF registry","volume":"55","author":"Romiti","year":"2023","journal-title":"EClinicalMedicine"},{"key":"2026071807411438500_qcag108-B7","doi-asserted-by":"crossref","first-page":"2836","DOI":"10.1093\/eurheartj\/ehaa055","article-title":"Integrated management of atrial fibrillation in primary care: results of the ALL-IN cluster randomized trial","volume":"41","author":"van Den Dries","year":"2020","journal-title":"Eur Heart J"},{"key":"2026071807411438500_qcag108-B8","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1370\/afm.23","article-title":"Defining and measuring interpersonal continuity of care","volume":"1","author":"Saultz","year":"2003","journal-title":"Ann Fam Med"},{"key":"2026071807411438500_qcag108-B9","doi-asserted-by":"crossref","first-page":"953","DOI":"10.1136\/bmjqs.2010.050864","article-title":"Characteristics of general practices associated with emergency-department attendance rates: a cross-sectional study","volume":"20","author":"Baker","year":"2011","journal-title":"BMJ Qual Saf"},{"key":"2026071807411438500_qcag108-B10","doi-asserted-by":"crossref","first-page":"e482","DOI":"10.3399\/bjgp13X669202","article-title":"Continuity of GP care is related to reduced specialist healthcare use: a cross-sectional survey","volume":"63","author":"Hansen","year":"2013","journal-title":"Br J Gen Pract"},{"key":"2026071807411438500_qcag108-B11","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2017-021161","article-title":"Continuity of care with doctors\u2014a matter of life and death? 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