{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T16:22:05Z","timestamp":1792686125243,"version":"4.5.0"},"reference-count":19,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2020,4,29]],"date-time":"2020-04-29T00:00:00Z","timestamp":1588118400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Atrial fibrillation (AF) is associated with substantially increased risk of cardiovascular events and overall mortality. The Atrial fibrillation Better Care (A\u2014Avoid stroke, B\u2014Better symptom management, C\u2014Cardiovascular and comorbidity risk management) pathway provides a simple and comprehensive approach for integrated AF therapy. This study\u2019s goals were to evaluate the ABC pathway compliance and determine the main gaps in AF management in the Middle East population, and to assess the impact of ABC pathway adherence on the all-cause mortality and composite outcome in AF patients. 2021 patients (mean age 57; 52% male) from the Gulf SAFE registry were studied. We evaluated: A\u2014appropriate implementation of OACs according to CHA2DS2-VASc score; B\u2014symptom control according to European Heart Rhythm Association (EHRA) symptom scale; C\u2014proper cardiovascular comorbidities management. The primary endpoints were the composite cardiovascular outcome (ischemic stroke or systemic embolism, all-cause death and cardiovascular hospitalization) and all-cause mortality. One-hundred and sixty-eight (8.3%) patients were optimally managed according to adherence with the ABC pathway. Over the one-year follow up (FU), there were 578 composite outcome events and 224 deaths. Patients managed with integrated care had significantly lower rates for the composite outcome and mortality comparing to non-ABC group (20.8% vs. 29.3%, p = 0.02 and 7.3% vs. 13.1%, p = 0.033, respectively). On multivariable analysis, ABC compliance was independently associated with reduced risk of composite outcome (HR 0.53; 95% CI 0.36\u20130.8, p = 0.002) and death (HR 0.46; 95% CI 0.25\u20130.86, p = 0.015). Integrated ABC pathway adherent care resulted in the reduced composite outcome and all-cause mortality in AF patients from Middle East, highlighting the necessity of promoting comprehensive holistic and integrated care management of AF.<\/jats:p>","DOI":"10.3390\/jcm9051286","type":"journal-article","created":{"date-parts":[[2020,4,29]],"date-time":"2020-04-29T13:23:45Z","timestamp":1588166625000},"page":"1286","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Compliance of Atrial Fibrillation Treatment with the Atrial Fibrillation Better Care (ABC) Pathway Improves the Clinical Outcomes in the Middle East Population: A Report from the Gulf Survey of Atrial Fibrillation Events (SAFE) Registry"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0575-9150","authenticated-orcid":false,"given":"Jakub","family":"Gumprecht","sequence":"first","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart &amp; Chest Hospital, Liverpool L7-8TX, UK"},{"name":"Department of Cardiology, Medical University of Silesia, Silesian Centre for Heart Diseases, 41-800 Zabrze, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magdalena","family":"Domek","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart &amp; Chest Hospital, Liverpool L7-8TX, UK"},{"name":"Department of Internal Diseases, Diabetology and Nephrology, Medical University of Silesia, 41-800 Zabrze, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1452-2478","authenticated-orcid":false,"given":"Marco","family":"Proietti","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart &amp; Chest Hospital, Liverpool L7-8TX, UK"},{"name":"Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9121-1887","authenticated-orcid":false,"given":"Yan-Guang","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Peking University Third Hospital, Beijing 100191, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nidal","family":"Asaad","sequence":"additional","affiliation":[{"name":"Cardiology Department, Heart Hospital, Hamad Medical Corporation, Doha 3050, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wafa","family":"Rashed","sequence":"additional","affiliation":[{"name":"Department of Medicine, Mubarak Al-Kabeer Hospital, Jabriya, Kuwait University, Kuwait City 24923, Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alawi","family":"Alsheikh-Ali","sequence":"additional","affiliation":[{"name":"College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai 505055, UAE"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Zubaid","sequence":"additional","affiliation":[{"name":"Department of Medicine, Mubarak Al-Kabeer Hospital, Jabriya, Kuwait University, Kuwait City 24923, Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7566-1626","authenticated-orcid":false,"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 L7-8TX, UK"},{"name":"Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, 9100 Aalborg, Denmark"},{"name":"Department of Cardiology, Medical University of Silesia, Silesian Centre for Heart Diseases, 41-800 Zabrze, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,4,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"8","DOI":"10.4103\/2231-0770.173580","article-title":"The current approach of atrial fibrillation management","volume":"6","author":"Amin","year":"2016","journal-title":"Avicenna J. 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