Strengths and limitations
EVENTS, SECONDARY, THROMBOEMBOLISM
This is the first analysis to investigate the effect of a mHealth-implemented ABC pathway in AF patients with previous thromboembolism, thus offering an unparalleled outlook on a high-risk subgroup of AF patients. Furthermore, the results on the primary outcome were consistent with the main trial’s analysis. However, our study has also some limitations. First, this is a post-hoc analysis, and therefore lacks statistical power in the subgroup of patients with history of previous thromboembolism. This particularly apply to the results of the secondary outcomes, especially given the relative low number of events; therefore, these findings should be regarded as explorative. Despite the differences of baseline characteristics among patients allocated to mAFA intervention and usual care in both groups, we implemented an IPTW analysis using a subgroup-balancing PS based on an extensive number of variables. Notwithstanding these limitations, we cannot exclude the contribution of other unaccounted confounders on the results observed, and the results reported should be therefore interpreted with caution. Finally, we were unable to analyze data regarding socioeconomical factors or quality of anticoagulation, which may have influenced the results observed and the difference between primary and secondary prevention AF patients.