{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T22:57:32Z","timestamp":1793141852993,"version":"4.5.0"},"reference-count":38,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,1,7]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Heart failure (HF) often occurs in patients with atrial fibrillation (AF), with a major impact on prognosis. Few data are available on the effect of integrated treatment strategies to improve prognosis in patients with AF. We aimed to evaluate the association between HF (according to left ventricular ejection fraction [LVEF]), HF optimal medical therapy and adherence to the Atrial Fibrillation Better Care pathway, and major outcomes in patients with AF.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">From the ESC\u2010EHRA EORP\u2010AF (European Society of Cardiology\u2013European Heart Rhythm Association EURObservational Research Programme in Atrial Fibrillation) General Long\u2010Term Registry, we evaluated patients with HF, categorized according to LVEF (HF with reduced ejection fraction, HF with mildly reduced ejection fraction, HF with preserved ejection fraction). Optimal medical therapy for HF was guidelines\u2010defined. The primary end point was the composite of all\u2010cause death and major adverse cardiovascular events. From the original cohort, 9373 (84.5%) patients were included in this analysis (median age, 71 [interquartile range, 62\u201377] years; 39.9% women). Compared with no HF, all HF categories were associated with an increased risk of the primary composite outcome, with highest figures observed for HF with reduced ejection fraction (hazard ratio [HR], 2.36 [95% CI, 2.00\u20132.78]). The risk was reduced in patients with AF and HF adherent to optimal medical therapy (HR, 0.83 [95% CI, 0.70\u20130.98]), as well as in those adherents to the Atrial Fibrillation Better Care pathway (HR, 0.65 [95% CI, 0.48\u20130.88]). The effect of Atrial Fibrillation Better Care pathway was consistent across the spectrum of LVEF.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Patients with AF and HF have a high risk of major adverse events, and this risk is inversely associated with LVEF. Atrial Fibrillation Better Care pathway adherent management is associated with improved clinical outcomes in patients with HF, across the spectrum of LVEF.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.123.030499","type":"journal-article","created":{"date-parts":[[2024,12,20]],"date-time":"2024-12-20T11:23:27Z","timestamp":1734693807000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Optimal Medical Therapy for Heart Failure and Integrated Care in Patients With Atrial Fibrillation: A Report From the ESC\u2010EHRA EORP Atrial Fibrillation Long\u2010Term General Registry"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2766-5286","authenticated-orcid":false,"given":"Niccol\u00f2","family":"Bonini","sequence":"first","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart &amp; Chest Hospital Liverpool United Kingdom"},{"name":"Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences University of Modena and Reggio Emilia, Policlinico di Modena Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1452-2478","authenticated-orcid":false,"given":"Marco","family":"Proietti","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences and Community Health University of Milan Milan Italy"},{"name":"Division of Subacute Care IRCCS Istituti Clinici Scientifici Maugeri Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3788-8942","authenticated-orcid":false,"given":"Giulio Francesco","family":"Romiti","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart &amp; Chest Hospital Liverpool United Kingdom"},{"name":"Department of Translational and Precision Medicine Sapienza\u2014University of Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5196-6249","authenticated-orcid":false,"given":"Marco","family":"Vitolo","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart &amp; Chest Hospital Liverpool United Kingdom"},{"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":"Ameenathul Mazaya","family":"Fawzy","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart &amp; Chest Hospital Liverpool United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3596-6545","authenticated-orcid":false,"given":"Wern Yew","family":"Ding","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart &amp; Chest Hospital Liverpool United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3403-3364","authenticated-orcid":false,"given":"Jacopo Francesco","family":"Imberti","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart &amp; Chest Hospital Liverpool United Kingdom"},{"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"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9267-1658","authenticated-orcid":false,"given":"Laurent","family":"Fauchier","sequence":"additional","affiliation":[{"name":"Service de Cardiologie Centre Hospitalier Universitaire Trousseau Tours France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7246-7708","authenticated-orcid":false,"given":"Francisco","family":"Marin","sequence":"additional","affiliation":[{"name":"Department of Cardiology Hospital Universitario Virgen de la Arrixaca, IMIB\u2010Arrixaca, University of Murcia, CIBER\u2010CV Murcia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Nabauer","sequence":"additional","affiliation":[{"name":"Department of Cardiology Ludwig\u2010Maximilians\u2010University Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9867-2582","authenticated-orcid":false,"given":"Gheorghe Andrei","family":"Dan","sequence":"additional","affiliation":[{"name":"University of Medicine, \u2018Carol Davila\u2019 Colentina University Hospital Bucharest Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6285-6902","authenticated-orcid":false,"given":"Tatjana S.","family":"Potpara","sequence":"additional","affiliation":[{"name":"School of Medicine University of Belgrade Serbia"},{"name":"Intensive Arrhythmia Care, Cardiology Clinic Clinical Center of Serbia Belgrade Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9820-4815","authenticated-orcid":false,"given":"Giuseppe","family":"Boriani","sequence":"additional","affiliation":[{"name":"Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences University of Modena and Reggio Emilia, Policlinico di Modena Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7566-1626","authenticated-orcid":false,"given":"Gregory Y. 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