Australia should be regarded as a ‘hot bed’ when it comes to research involving new atrial fibrillation models of care, said Professor Simon Stewart director of the Mary MacKillop Institute for Health Research in Melbourne, speaking to delegates attending a session on heart failure.
But he also said there are challenges translating that research on the world stage.
According to Professor Stewart the SAFETY trial reported in The Lancet was the first study to examine the benefits of AF- specific care on AF hospital re-admission and survival.
While the intervention didn’t stop patients from having an event requiring hospitalisation, it did prolong a second, and arguably more important, primary endpoint – days alive out of hospital, he said.
According to Professor Stewart, for every 100 patients with AF exposed to the SAFETY management program there were seven fewer deaths, 900 fewer days of costly hospital stay, and 1000 more days alive and out-of-hospital compared to standard care.
But in 2016 when the European Cardiac Society updated its guidelines on AF management Professor Stewart said it dismissed the trial describing the intervention as only having a ‘marginal effect’ on unplanned admissions and death.
“In terms of survival SAFETY showed a six percent absolute difference between the intervention and control groups in favour of the intervention. That’s quite a profound impact. Coming back to the ESC guidelines, that’s not a marginal effect,” he told delegates.
“When you examine what we found in SAFETY I think we’ve got a fair case for disagreeing with their statement,” he added.
“But there’s the battle we face presenting Australian data and it being interpreted in places like Europe and the US, it’s difficult for us to get some breakthrough.”