{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T04:37:51Z","timestamp":1785818271472,"version":"3.56.0"},"reference-count":31,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,2,2]],"date-time":"2021-02-02T00:00:00Z","timestamp":1612224000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Eur J Clin Investigation"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Integrated care for management of atrial fibrillation (AF) patients has been associated with a reduction in adverse events. The \u2018Atrial fibrillation Better Care (ABC) pathway\u2019 has been proposed to streamline such integrated management. In this paper, we analysed the impact of ABC pathway adherent clinical management on outcomes in AF patients with high\u2010risk \u2018metabolic\u2019 comorbidities (i.e. diabetes mellitus [DM], chronic kidney disease [CKD], metabolic syndrome [MetS].<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients from the SPORTIF III and V trials and with available data to evaluate ABC criteria were analysed. DM, CKD and MetS were evaluated according to baseline data. A composite of major adverse cardiovascular events and all\u2010cause death was the study outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 3637 patients (median age 72 [IQR 66\u201077], 30.3% female) were analysed. DM was evident in 23.4%, CKD in 25.8% and MetS in 31.5% among the overall cohort. Respectively, 23.2% were ABC pathway adherent in the DM subgroup, 21.2% in CKD and 23.7% in MetS subgroups. Composite outcome occurred less frequently in patients managed adherent to ABC pathway than those nonadherents, in all three groups. In the final multivariate model, ABC adherent care was inversely associated with a lower risk of composite outcome in the DM (HR 0.45, 95% CI 0.23\u20100.88), CKD (HR 0.60, 95% CI 0.36\u20100.98) and MetS (HR 0.37, 95% CI 0.19\u20100.71) subgroups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In high\u2010risk AF patients with DM, CKD and MetS, ABC pathway adherent management was associated with a lowered risk of the composite outcome of cardiovascular events, cardiovascular and all\u2010cause death.<\/jats:p><\/jats:sec>","DOI":"10.1111\/eci.13498","type":"journal-article","created":{"date-parts":[[2021,1,23]],"date-time":"2021-01-23T05:27:10Z","timestamp":1611379630000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":35,"title":["Integrated care and outcomes in patients with atrial fibrillation and comorbidities"],"prefix":"10.1111","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1452-2478","authenticated-orcid":false,"given":"Marco","family":"Proietti","sequence":"first","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science University of Liverpool and Liverpool Heart &amp; Chest Hospital Liverpool UK"},{"name":"Department of Clinical Sciences and Community Health University of Milan Milan Italy"},{"name":"Geriatric Unit IRCCS Istituti Clinici Scientifici Maugeri Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Vitolo","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science University of Liverpool and Liverpool Heart &amp; Chest Hospital Liverpool UK"},{"name":"Cardiology Division Department of Biomedical, Metabolic and Neural Sciences University of Modena and Reggio Emilia Policlinico Di Modena Modena Italy"},{"name":"Clinical and Experimental Medicine PhD Program University of Modena and Reggio Emilia Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory Y. H.","family":"Lip","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science University of Liverpool and Liverpool Heart &amp; Chest Hospital Liverpool UK"},{"name":"Aalborg Thrombosis Research Unit Department of Clinical Medicine Faculty of Health Aalborg University Aalborg 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