Discussion
death, AF, stroke, thromboembolic, ischemic stroke, embolism
THROMBOEMBOLIC EVENT, STROKE, ISCHEMIC STROKE, SECONDARY, THROMBOEMBOLISM, EMBOLISM
In this post-hoc analysis of the mAFA-II trial on secondary prevention AF patients, our main results are the following: (1) patients with history of stroke or systemic embolism had a significantly higher burden of cardiovascular risk factors and comorbidities compared to those without prior stroke or systemic embolism; (2) the effect of mAFA intervention on the primary composite outcome of all-cause death, ischemic stroke or systemic embolism, and rehospitalization remained consistent in both patients in primary or secondary thromboembolic risk prevention, with no statistically significant interaction; and (3) the effect mAFA intervention on the risk of the exploratory secondary outcomes was lower among patients with previous thromboembolism.Although the rate of ischemic stroke in patients with AF is declining, a significant proportion of AF patients still experience thromboembolic events Indeed, our study shows that AF patients with a history of ischemic stroke or systemic embolism have a significantly higher burden of cardiovascular risk factors and comorbidities. Accordingly, previous studies showed a high prevalence of different cardiovascular and non-cardiovascular comorbidities among patients with AF and previous ischemic stroke, which significantly contributed to higher risk of future thromboembolic events [Nevertheless, the primary analysis of the mAFA-II has shown that an integrated AF treatment plan, incorporating the mHealth-implemented ABC pathway, significantly reduced the risk of the primary outcome in patients with AF [Our results are consistent with previous evidence on the efficacy of the ABC pathway pathway in clinically complex patients [Indeed, several hypotheses can explain these findings. First, patients with stroke usually requires integrated and tailored approach to promote rehabilitation and achieve better functional outcomes [Consistently, our findings suggest that an ABC-adherent management is associated with improved outcomes among AF patients, as previously shown [