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AF, alcohol and kidney function

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Nurse-led AF care beats cardiologist care
European Heart Journal (2012) 33;2692-2699

Nurse-led care of patients with stable atrial fibrillation (AF) reduces cardiovascular hospitalisations and mortality by more than a third compared to the usual care provided by cardiologists, according to a study that enrolled at total of 712 patients.

Nurse-led care was based on guidelines, supervised by a cardiologist and supported by decision-making software that proposed management based on the patient's symptoms, AF type and stroke risk. Nurse-led care improved adherence to guidelines compared to the usual care provided by cardiologists.

For example, after the first visit, 99 per cent of patients managed with nurse-led care received appropriate antithrombotic treatment compared to 83 per cent with usual care. Furthermore, 91 per cent and 54 per cent of the nurse-led and usual care groups respectively underwent thyroid function testing, while 91 per cent and 82 per cent respectively received echocardiography.

After a mean of 22 months, 14.3 per cent of patients managed by nurse-led care died from, or were hospitalised with, cardiovascular causes, compared to 20.8 per cent of the usual care arm, a 35 per cent reduction.

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