Compliance with the ABC pathway for integrated care of patients with atrial fibrillation in Brazil: a retrospective cohort study

Background Information about integrated care for patients with atrial fibrillation (AF) in low- and middle-income countries is scarceMethods We analyzed multicentre data from 699 patients with AF treated in São Paulo, Brazil. ABC compliance was defined as (1) adequate anticoagulation (‘A’ component); (2) controlled AF symptoms (‘B’ component); and (3) comorbidities treatment (‘C’ component). We built logistic regression models to identify characteristics associated with ABC complianceResults Mean age was 69.4 ± 14.4 years (45.8% women; 57.4% from private healthcare). Compliance with ABC pathway, and with the ‘A,’ ‘B’ and ‘C’ components occurred in 20.9%, 42.3%, 81.7% and 50.1% of the participants, respectively. Lack of ABC compliance was associated with female sex (adjusted odds ratio [aOR]:1.66; p = 0.015), intermediate (aOR:3.37; p < 0.001) and high (aOR:9.17; p < 0.001) bleeding risk. Patients with AF treated in public units had worse performance for the ‘A’ component (aOR:2.50; p < 0.001) and better performance for the ‘C’ component (aOR:0.49; p < 0.001) compared to those using private healthcare.Conclusions Compliance with the ABC pathway in São Paulo, Brazil was low. Lack of ABC compliance was more common in women and individuals with high bleeding risk. We found a mixed pattern of ABC compliance in public and private units.