Integrated Care Management of Patients With Atrial Fibrillation and Risk of Cardiovascular Events: The ABC (Atrial fibrillation Better Care) Pathway in the ATHERO-AF Study Cohort.

Abstract:

OBJECTIVE:To investigate the impact on cardiovascular events (CVEs) in a real-world population of patients with atrial fibrillation (AF) by implementing the Atrial fibrillation Better Care (ABC: A, Avoid stroke with anticoagulation; B, better symptom management; C, Cardiovascular and comorbidity risk management) pathway. PATIENTS AND METHODS:This prospective single-center cohort study included 907 consecutive patients with nonvalvular AF on vitamin K antagonists from February 2008 to December 2016. The A, B, and C groups were defined as follows: "A" by a Time in Therapeutic Range ≥65%; "B" by a European Heart Rhythm Association (EHRA) symptom scale I-II, and "C" as optimized cardiovascular comorbidity management. Primary end point was a composite outcome of CVEs. RESULTS:During a median follow-up of 36.9 months (interquartile range [IQR] 20.0-57.5; 3022 patient-years), 118 CVEs occurred (3.9% per year; 95% confidence interval [CI], 3.2-4.7). Symptomatic patients (EHRA III-IV) had a higher risk of CVEs compared with those in EHRA I (hazard ratio [HR], 2.73, 95% CI, 1.61-4.63, P<.001). Optimally managed patients in the ABC group (n=198) had a lower risk of CVEs (1.8 [95% CI, 0.9-3.0] vs 4.5% [95% CI, 3.7-5.5] per year, P=.001) compared with those presenting with at least 1 suboptimal ABC factor (HR, 0.40, 95% CI, 0.22-0.74, P=.003). This association was evident using multivariate Cox proportional regression analysis (HR, 0.44, 95% CI, 0.24-0.80, P=.007). CONCLUSION:Integrated care management according to the ABC pathway resulted in a significantly lower rate of CVEs, suggesting a clear benefit of a holistic approach to optimize the management of patients with AF. TRIAL REGISTRATION:clinicaltrials.gov Identifier: NCT01882114.

journal_name

Mayo Clin Proc

journal_title

Mayo Clinic proceedings

authors

Pastori D,Pignatelli P,Menichelli D,Violi F,Lip GYH

doi

10.1016/j.mayocp.2018.10.022

subject

Has Abstract

pub_date

2019-07-01 00:00:00

pages

1261-1267

issue

7

eissn

0025-6196

issn

1942-5546

pii

S0025-6196(18)30891-7

journal_volume

94

pub_type

杂志文章
  • Bloodstream infections in patients with pulmonary arterial hypertension treated with intravenous prostanoids: insights from the REVEAL REGISTRY®.

    abstract:OBJECTIVE:To evaluate the rate of and potential risk factors for bloodstream infections (BSIs) using data from the REVEAL (Registry to Evaluate Early and Long-term Pulmonary Arterial Hypertension [PAH] Disease Management) REGISTRY(®), which provides current information about patients with PAH. PATIENTS AND METHODS:Pat...

    journal_title:Mayo Clinic proceedings

    pub_type: 杂志文章,多中心研究

    doi:10.1016/j.mayocp.2012.05.014

    authors: Kitterman N,Poms A,Miller DP,Lombardi S,Farber HW,Barst RJ

    更新日期:2012-09-01 00:00:00

  • Elevated bone aluminum content in dialysis patients without osteomalacia.

    abstract::In almost all dialysis patients, bone aluminum content (BAC) is elevated in comparison with levels in normal subjects. Extremely high BAC (200 micrograms or more of aluminum per gram of bone) is significantly associated with classic aluminum-related osteomalacia. We noted three patients with elevated BAC but without h...

    journal_title:Mayo Clinic proceedings

    pub_type: 杂志文章

    doi:10.1016/s0025-6196(12)60539-4

    authors: McCarthy JT,Kurtz SB,McCall JT

    更新日期:1985-05-01 00:00:00

  • Developing a Conversation Aid to Support Shared Decision Making: Reflections on Designing Anticoagulation Choice.

    abstract::Patient-centered care requires that treatments respond to the problematic situation of each patient in a manner that makes intellectual, emotional, and practical sense, an achievement that requires shared decision making (SDM). To implement SDM in practice, tools-sometimes called conversation aids or decision aids-are...

    journal_title:Mayo Clinic proceedings

    pub_type: 杂志文章,评审

    doi:10.1016/j.mayocp.2018.08.030

    authors: Zeballos-Palacios CL,Hargraves IG,Noseworthy PA,Branda ME,Kunneman M,Burnett B,Gionfriddo MR,McLeod CJ,Gorr H,Brito JP,Montori VM,Shared Decision Making for Atrial Fibrillation (SDM4AFib) Trial Investigators.

    更新日期:2019-04-01 00:00:00

  • Liver renewal: detecting misrepair and optimizing regeneration.

    abstract:UNLABELLED:Cirrhosis and liver cancer, the main causes of liver-related morbidity and mortality, result from defective repair of liver injury. This article summarizes rapidly evolving knowledge about liver myofibroblasts and progenitors, the 2 key cell types that interact to orchestrate effective repair, because deregu...

    journal_title:Mayo Clinic proceedings

    pub_type: 杂志文章

    doi:10.1016/j.mayocp.2013.10.009

    authors: Machado MV,Diehl AM

    更新日期:2014-01-01 00:00:00

  • Ovarian dysgerminoma: a retrospective analysis of results of treatment, sites of treatment failure, and radiosensitivity.

    abstract::Thirty-five patients with a diagnosis of pure ovarian dysgerminoma underwent assessment at our institution between 1950 and 1984. The median age of these patients was 21 years (range, 8 to 41 years). The surgical pathologic stages of the tumors were as follows: stage IA1 in 18 patients, stage IA2 in 2, stage IB1 in 2,...

    journal_title:Mayo Clinic proceedings

    pub_type: 杂志文章

    doi:10.1016/s0025-6196(12)62512-9

    authors: Buskirk SJ,Schray MF,Podratz KC,Lee RA,Stanhope CR,Gaffey TA,Weber FC,Earle JD,Naessens JM,Malkasian GD

    更新日期:1987-12-01 00:00:00

  • The German Pflegeversicherung (long-term care insurance).

    abstract::The German Pflegeversicherung, introduced in January 1995, has been very successful. It has been well accepted by persons in need and by their relatives and friends, providing benefits for both parties. The insurance is financially sound and has helped to create new workplaces. ...

    journal_title:Mayo Clinic proceedings

    pub_type: 杂志文章

    doi:10.4065/74.2.196

    authors: Wahner-Roedler DL,Knuth P,Juchems RH

    更新日期:1999-02-01 00:00:00

  • Cessation of unsuccessful pediatric resuscitation--how long is too long?

    abstract::Emergency teams asked to provide cardiopulmonary resuscitation for pediatric patients often consist of nurses and physicians from various pediatric and nonpediatric specialties. Team members should agree on the timing of termination of unsuccessful resuscitative efforts; however, no firm guidelines about such timing h...

    journal_title:Mayo Clinic proceedings

    pub_type: 杂志文章

    doi:10.1016/s0025-6196(12)60126-8

    authors: O'Marcaigh AS,Koenig WJ,Rosekrans JA,Berseth CL

    更新日期:1993-04-01 00:00:00

  • Symptomatic hyperthyroidism in a patient taking the dietary supplement tiratricol.

    abstract::An 87-year-old woman was referred for evaluation of nervousness, tremor, insomnia, and fatigue of 2 months' duration. Initial laboratory evaluation revealed a suppressed thyrotropin level and an elevated triiodothyronine level. A review of her medications revealed that she had started taking several dietary supplement...

    journal_title:Mayo Clinic proceedings

    pub_type: 杂志文章

    doi:10.4065/77.6.587

    authors: Bauer BA,Elkin PL,Erickson D,Klee GG,Brennan MD

    更新日期:2002-06-01 00:00:00

  • Genetics of cerebrovascular disorders.

    abstract::Physicians must be able to recognize stroke caused by a mendelian or mitochondrial disorder. Some genetic disorders such as sickle cell anemia and Fabry disease have proven disease-specific treatments, whereas others have no effective treatment, including cerebral autosomal dominant arteriopathy with subcortical infar...

    journal_title:Mayo Clinic proceedings

    pub_type: 杂志文章,评审

    doi:10.1016/S0025-6196(11)62969-8

    authors: Meschia JF,Brott TG,Brown RD Jr

    更新日期:2005-01-01 00:00:00

  • A reappraisal of clinical, roentgenographic, and endoscopic features of the Zollinger-Ellison syndrome.

    abstract::Recent experience with 40 patients with the Zollinger-Ellison syndrome at all Mayo Clinic suggests that traditional clinical criteria for diagnosis are often absent or invalid. Patients are younger have a shorter duration of symptoms, and often present without prior gastric surgery. Clinical, roentgenographic, and end...

    journal_title:Mayo Clinic proceedings

    pub_type: 杂志文章

    doi:

    authors: Regan PT,Malagelada JR

    更新日期:1978-01-01 00:00:00

  • Spurious hypocalcemia after gadodiamide administration.

    abstract::Severe hypocalcemia may require prompt intervention to avoid life-threatening consequences. We report a case in which a 78-year-old man had a critically low serum calcium level measured with use of standard colorimetric assay after gadodiamide administration during magnetic resonance angiography. Reanalysis of the sam...

    journal_title:Mayo Clinic proceedings

    pub_type: 杂志文章

    doi:10.4065/80.12.1655

    authors: Williams SF,Meek SE,Moraghan TJ

    更新日期:2005-12-01 00:00:00

  • Telemedicine and the diagnosis of speech and language disorders.

    abstract:OBJECTIVE:To summarize results of telemedicine evaluations of speech and language disorders in patients in a small, rural hospital and in large multidisciplinary medical practices. MATERIALS AND METHODS:Eight patients underwent assessment as part of experiments with the National Aeronautics and Space Administration-la...

    journal_title:Mayo Clinic proceedings

    pub_type: 杂志文章

    doi:10.4065/72.12.1116

    authors: Duffy JR,Werven GW,Aronson AE

    更新日期:1997-12-01 00:00:00

  • Potential effect of authorization bias on medical record research.

    abstract:OBJECTIVE:To analyze the influence of recent changes in Minnesota statutes that generally require prior authorization for use of medical records for research from patients who received medical care after Jan. 1, 1997. MATERIAL AND METHODS:In this Mayo Clinic Institutional Review Board-approved study, we obtained a str...

    journal_title:Mayo Clinic proceedings

    pub_type: 杂志文章

    doi:10.4065/74.4.330

    authors: Jacobsen SJ,Xia Z,Campion ME,Darby CH,Plevak MF,Seltman KD,Melton LJ 3rd

    更新日期:1999-04-01 00:00:00

  • Changes in the Relationships Between Body Mass Index and Health Outcomes Across Middle Age and Older Adulthood.

    abstract:OBJECTIVE:To examine patterns of the incidence of diabetes, hypertension, and mortality by single units of body mass index (BMI) and 5-year age groups using longitudinal data from middle-aged and older women. PATIENTS AND METHODS:Middle-aged (born between 1946 and 1951; N = 13,715) and older (born between 1921 and 192...

    journal_title:Mayo Clinic proceedings

    pub_type: 杂志文章,多中心研究

    doi:10.1016/j.mayocp.2015.04.006

    authors: Peeters GM,Herber-Gast GC,Dobson AJ,Brown WJ

    更新日期:2015-07-01 00:00:00

  • Causes of death in patients with tuberous sclerosis.

    abstract::Of the 355 patients with tuberous sclerosis complex (TSC) examined at the Mayo Clinic, 49 had died (9 of causes other than TSC). We attempted to determine what pattern of organ involvement occurred most often in the 40 patients who died of TSC. One baby died of cardiac failure due to cardiac rhabdomyomas, and one chil...

    journal_title:Mayo Clinic proceedings

    pub_type: 杂志文章

    doi:10.1016/s0025-6196(12)61196-3

    authors: Shepherd CW,Gomez MR,Lie JT,Crowson CS

    更新日期:1991-08-01 00:00:00

  • Aspergillus infection of implantable cardioverter-defibrillator.

    abstract::The use of pacemakers and implantable cardioverter-defibrillators continues to increase for the management of cardiac dysrhythmias and, more recently, heart failure. Long-term complications associated with their use include infection, lead failure, and spurious shocks. Although the risk of infection with intracardiac ...

    journal_title:Mayo Clinic proceedings

    pub_type: 杂志文章,评审

    doi:10.4065/79.4.549

    authors: Cook RJ,Orszulak TA,Nkomo VT,Shuford JA,Edwards WD,Ryu JH

    更新日期:2004-04-01 00:00:00

  • Effects of a medical intensivist on patient care in a community teaching hospital.

    abstract:OBJECTIVE:To determine the effect of adding a trained intensivist on patient care and educational outcomes in a community teaching hospital. MATERIAL AND METHODS:We retrospectively reviewed outcomes for patients admitted to the medical intensive-care unit (MICU) of a 270-bed community teaching hospital between July 19...

    journal_title:Mayo Clinic proceedings

    pub_type: 杂志文章

    doi:10.4065/72.5.391

    authors: Manthous CA,Amoateng-Adjepong Y,al-Kharrat T,Jacob B,Alnuaimat HM,Chatila W,Hall JB

    更新日期:1997-05-01 00:00:00

  • Percutaneous transcatheter embolization of coronary arteriovenous fistulas.

    abstract::Coronary artery fistulas are infrequently encountered vascular communications that are either congenital or due to cardiac trauma. Most patients with these anomalies are asymptomatic, but late complications can occur and include congestive heart failure, myocardial ischemia, arrhythmias, and endocarditis. Therefore, m...

    journal_title:Mayo Clinic proceedings

    pub_type: 杂志文章

    doi:10.4065/71.1.37

    authors: Harris WO,Andrews JC,Nichols DA,Holmes DR Jr

    更新日期:1996-01-01 00:00:00

  • Strategies for optimizing glycemic control and cardiovascular prognosis in patients with type 2 diabetes mellitus.

    abstract::Type 2 diabetes mellitus (DM) is a major cardiovascular (CV) risk factor and, as such, is considered a coronary artery disease risk equivalent. Although glycemic control is associated with decreased CV events epidemiologically, many prospective clinical trials have failed to conclusively demonstrate that aggressive gl...

    journal_title:Mayo Clinic proceedings

    pub_type: 杂志文章,评审

    doi:10.4065/mcp.2010.0434

    authors: O'Keefe JH,Abuannadi M,Lavie CJ,Bell DS

    更新日期:2011-02-01 00:00:00

  • Thyroid Status and Death Risk in US Veterans With Chronic Kidney Disease.

    abstract:OBJECTIVE:Given that patients with non-dialysis-dependent chronic kidney disease (NDD-CKD) have a disproportionately higher prevalence of hypothyroidism compared with their non-CKD counterparts, we sought to determine the association between thyroid status, defined by serum thyrotropin (TSH) levels, and mortality among...

    journal_title:Mayo Clinic proceedings

    pub_type: 杂志文章

    doi:10.1016/j.mayocp.2018.01.024

    authors: Rhee CM,Kalantar-Zadeh K,Ravel V,Streja E,You AS,Brunelli SM,Nguyen DV,Brent GA,Kovesdy CP

    更新日期:2018-05-01 00:00:00

  • A sporadic case of pneumonia due to legionnaires disease.

    abstract::A recently recognized sporadic case of "legionnaires' disease" occuring in Minnesota is described. The patient, a previously healthy 58-year-old woman, became seriously ill with progressive pneumonia in the spring of 1977. Her illness was unresponsive to the usual antibiotics (penicillin and cephalothin) prescribed fo...

    journal_title:Mayo Clinic proceedings

    pub_type: 杂志文章

    doi:

    authors: Keys TF

    更新日期:1977-10-01 00:00:00

  • Physical exercise as a preventive or disease-modifying treatment of dementia and brain aging.

    abstract::A rapidly growing literature strongly suggests that exercise, specifically aerobic exercise, may attenuate cognitive impairment and reduce dementia risk. We used PubMed (keywords exercise and cognition) and manuscript bibliographies to examine the published evidence of a cognitive neuroprotective effect of exercise. M...

    journal_title:Mayo Clinic proceedings

    pub_type: 杂志文章,评审

    doi:10.4065/mcp.2011.0252

    authors: Ahlskog JE,Geda YE,Graff-Radford NR,Petersen RC

    更新日期:2011-09-01 00:00:00

  • Comparison of cardiovascular event rates in patients without cardiovascular disease in whom atorvastatin or simvastatin was newly initiated.

    abstract:OBJECTIVE:To compare cardiovascular (CV) event rates and risk in patients without previous CV disease in whom atorvastatin or simvastatin was newly initiated in a managed care setting. PATIENTS AND METHODS:Patients aged 18 to 64 years in whom atorvastatin or simvastatin was newly initiated between January 1, 2003, and...

    journal_title:Mayo Clinic proceedings

    pub_type: 杂志文章

    doi:10.1016/S0025-6196(11)60779-9

    authors: Jacobson TA,Wertz DA,Hoy T,Kuznik A,Grochulski D,Cziraky M

    更新日期:2008-12-01 00:00:00

  • Scleromyxedema: a complete response to prednisone.

    abstract::Scleromyxedema is a disorder characterized by a typical rash due to the accumulation of mucin in the dermis. It is always associated with a monoclonal protein in the serum and can have a wide variety of systemic manifestations. We describe a 40-year-old woman who had scleromyxedema associated with a monoclonal G lambd...

    journal_title:Mayo Clinic proceedings

    pub_type: 杂志文章

    doi:10.4065/74.5.481

    authors: Rayson D,Lust JA,Duncan A,Su WP

    更新日期:1999-05-01 00:00:00

  • Benefits and risks of long-term amiodarone therapy for persistent atrial fibrillation: a meta-analysis.

    abstract:OBJECTIVE:To assess whether amiodarone, as part of a strategy to achieve sinus rhythm, is safe and effective compared with a placebo or rate control drug in patients with persistent atrial fibrillation (AF) of more than 30 days' duration. METHODS:Randomized controlled trials comparing amiodarone with a placebo or rate...

    journal_title:Mayo Clinic proceedings

    pub_type: 杂志文章,meta分析

    doi:10.1016/S0025-6196(11)61140-3

    authors: Doyle JF,Ho KM

    更新日期:2009-03-01 00:00:00

  • Association between albuminuria and duration of diabetes and myocardial dysfunction and peripheral arterial disease among patients with stable coronary artery disease in the BARI 2D study.

    abstract:OBJECTIVE:To evaluate the effect of prior duration of diabetes, glycated hemoglobin level at study entry, and microalbuminuria or macroalbuminuria on the extent and severity of coronary artery disease (CAD) and peripheral arterial disease. PATIENTS AND METHODS:We studied baseline characteristics of the 2368 participan...

    journal_title:Mayo Clinic proceedings

    pub_type: 杂志文章

    doi:10.4065/mcp.2009.0265

    authors: Escobedo J,Rana JS,Lombardero MS,Albert SG,Davis AM,Kennedy FP,Mooradian AD,Robertson DG,Srinivas VS,Gebhart SS,BARI 2D Study Group.

    更新日期:2010-01-01 00:00:00

  • Computerized bar code-based blood identification systems and near-miss transfusion episodes and transfusion errors.

    abstract:OBJECTIVE:To determine whether the use of a computerized bar code-based blood identification system resulted in a reduction in transfusion errors or near-miss transfusion episodes. PATIENTS AND METHODS:Our institution instituted a computerized bar code-based blood identification system in October 2006. After instituti...

    journal_title:Mayo Clinic proceedings

    pub_type: 杂志文章

    doi:10.1016/j.mayocp.2012.12.010

    authors: Nuttall GA,Abenstein JP,Stubbs JR,Santrach P,Ereth MH,Johnson PM,Douglas E,Oliver WC Jr

    更新日期:2013-04-01 00:00:00

  • Effect of aspirin and antiplatelet drugs on the outcome of the fecal immunochemical test.

    abstract:OBJECTIVE:To evaluate the effect of aspirin and nonaspirin antiplatelet agents (NAAAs) on the performance of the fecal immunochemical test (FIT). PARTICIPANTS AND METHODS:We performed a post hoc analysis of results from a clinical trial that involved 28,696 asymptomatic average-risk men and women aged 50 to 69 years i...

    journal_title:Mayo Clinic proceedings

    pub_type: 临床试验,杂志文章

    doi:10.1016/j.mayocp.2013.04.016

    authors: Bujanda L,Lanas Á,Quintero E,Castells A,Sarasqueta C,Cubiella J,Hernandez V,Morillas JD,Perez-Fernández T,Salas D,Andreu M,Carballo F,Bessa X,Cosme A,Jover R,COLONPREV Study Investigators.

    更新日期:2013-07-01 00:00:00

  • Cardiovascular responses to immersion in a hot tub in comparison with exercise in male subjects with coronary artery disease.

    abstract::In order to test the safety of hot tub use for persons with heart disease, 15 men with clinically stable coronary artery disease underwent 15 minutes of immersion in a hot tube at 40 degrees C. On another day, they exercised on a cycle ergometer for 15 minutes; target heart rate was determined by standard methods. Tym...

    journal_title:Mayo Clinic proceedings

    pub_type: 临床试验,杂志文章

    doi:10.1016/s0025-6196(12)60014-7

    authors: Allison TG,Miller TD,Squires RW,Gau GT

    更新日期:1993-01-01 00:00:00

  • Update on Treatment of Clostridioides difficile Infection.

    abstract::Clostridioides difficile infection (CDI) is the leading cause of health care-associated infections in the United States. The increasing incidence and recurrence rates of CDI together with its associated morbidity and mortality are great concerns. Newer treatment methods, such as narrow-spectrum antibiotics, monoclonal...

    journal_title:Mayo Clinic proceedings

    pub_type: 杂志文章,评审

    doi:10.1016/j.mayocp.2019.08.006

    authors: Cho JM,Pardi DS,Khanna S

    更新日期:2020-04-01 00:00:00