Effect of Integrated Care on Patients With Atrial Fibrillation: A Systematic Review of Randomized Controlled Trials

Li，Yi1,2; Zhao，Wenjing3; Huang，Jun4; Zheng，Murui5; Hu，Peng1,2; Lu，Jiahai1; Deng，Hai6; Liu，Xudong2

2022-05-17

10.3389/fcvm.2022.904090

Frontiers in Cardiovascular Medicine   Impact Factor & Quartile

2297-055X

Aims: The integrated management was evidenced to improve the hospitalization and its associated complications in patients with atrial fibrillation (AF), but the strategies of integrated care varied and results were inconsistent. This systematic review and meta-analysis aimed to evaluate the effect of integrated care on AF-related outcomes with comparison with usual care. Methods: PubMed, Embase, and Web of Science were searched for articles published until 10th January 2022. Eligible studies were randomized controlled trials to study the effect of integrated care on AF-related outcomes. Meta-analysis with a random-effect model was used to calculate risk ratio (RR) and 95% confidence interval (CI) by comparing the integrated care with usual care. Results: A total of five studies with 6,486 AF patients were selected. By synthesizing available data, integrated care effectively reduced the risk of all-cause mortality (RR = 0.54, 95% CI = 0.42–0.69), cardiovascular hospitalization (RR = 0.72, 95% CI = 0.55–0.94), and cardiovascular mortality (RR = 0.52, 95% CI = 0.36–0.78) when compared with usual care; however, there was no superior effect on preventing AF-related hospitalization (RR = 0.86, 95% CI = 0.72–1.02), cerebrovascular events (RR = 1.13, 95% CI = 0.75–1.70), and major bleeding (RR = 1.29, 95% CI = 0.86–1.94) when comparing integrated care with usual care. Conclusion: Integrated care can reduce the risk of all-cause mortality, cardiovascular mortality, and cardiovascular hospitalizations in AF patients compared with usual care, while the benefit was not observed in other outcomes.

atrial fibrillation integrated care meta-analysis prognosis systematic review

SCI

English

Others

WOS:000805765800001

2-s2.0-85139030925

Scopus

1.Department of Epidemiology,School of Public Health,Sun Yat-sen University,Guangzhou,China
2.School of Public Health,Guangdong Pharmaceutical University,Guangzhou,China
3.School of Public Health and Emergency Management,Southern University of Science and Technology,Shenzhen,China
4.Department of Geriatrics,Institute of Geriatrics,Guangdong Provincial People’s Hospital,Guangdong Academy of Medical Science,Guangzhou,China
5.Guangzhou Center for Disease Control and Prevention,Guangzhou,China
6.Department of Cardiology,Guangdong Cardiovascular Institute,Guangdong Provincial People’s Hospital,Guangdong Academy of Medical Science,Guangzhou,China

Li，Yi,Zhao，Wenjing,Huang，Jun,et al. Effect of Integrated Care on Patients With Atrial Fibrillation: A Systematic Review of Randomized Controlled Trials[J]. Frontiers in Cardiovascular Medicine,2022,9.

Li，Yi.,Zhao，Wenjing.,Huang，Jun.,Zheng，Murui.,Hu，Peng.,...&Liu，Xudong.(2022).Effect of Integrated Care on Patients With Atrial Fibrillation: A Systematic Review of Randomized Controlled Trials.Frontiers in Cardiovascular Medicine,9.

Li，Yi,et al."Effect of Integrated Care on Patients With Atrial Fibrillation: A Systematic Review of Randomized Controlled Trials".Frontiers in Cardiovascular Medicine 9(2022).