Abstract 13602: Compliance With the Atrial Fibrillation Better Care (ABC) Pathway in Public and Private Healthcare Units From a Middle-Income Country

Introduction: The ABC pathway (A: Avoid stroke; B: Better symptoms; C: Comorbidities and lifestyle management) has been proposed to ensure a holistic or integrated care approach to atrial fibrillation (AF) management. There are scarce data about compliance with this strategy in low- and middle-income countries, where the AF populational burden is likely to increase. Hypothesis: Compliance with ABC pathway (ABC-compliance) in Brazil is low and associated with certain patient characteristics. Methods: We included 700 patients (46% women, 69±15 years) with confirmed AF. Participants were recruited from private and public healthcare units in São Paulo city. We built logistic regression models to analyze if age, sex, race, HAS-BLED scores, or healthcare sector (public or private) were associated with lack of ABC-compliance (Table 1). Results: ‘A’, ‘B’, ‘C’ and ABC-compliance occurred in 42%, 82%, 50%, and 21%, respectively. In multiple models (Table 2), lack of ABC-compliance was associated with female sex and high HAS-BLED scores. Lack of ‘B’ component compliance was associated with non-White race. Treatment in public units was positively associated with a lack of ‘A’ component compliance but this was inversely associated with a lack of ‘C’ component compliance. Age and ABC-compliance were not independently associated. Conclusions: Compliance with ABC pathway in our healthcare setting was low. Female sex and high HAS-BLED scores were markers of poor compliance with this integrated approach. Patients treated in private health units may have higher access to oral anticoagulants, while better comorbidity control in public health units may reflect a less segmented system of care.