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Improving Quality Measurement for Anticoagulation: Adding International Normalized Ratio Variability to Percent Time in Therapeutic Range Original Articles
Conclusions— Unstable anticoagulation predicts warfarin adverse effects independent of TTR. Moreover, knowledge about anticoagulation stability further stratifies the risk for adverse events at given levels of TTR.
Source: Circulation: Cardiovascular Quality and Outcomes - September 16, 2014 Category: Cardiology Authors: Razouki, Z., Ozonoff, A., Zhao, S., Jasuja, G. K., Rose, A. J. Tags: Coagulation, Coumarins, Thrombosis risk factors, Embolic stroke, Anticoagulants Original Articles Source Type: research

Abstract 100: Influence of Race on Presentation, Treatment, and Outcome Among Patients With Atrial Fibrillation-related Ischemic Stroke Session Title: Poster Session I
Conclusion: Blacks with AF who suffer IS are younger, have a higher burden of risk factors, and more often present with paroxysmal or new onset AF. IS in the setting of AF was associated with significant mortality and morbidity in both Blacks and Whites.
Source: Circulation: Cardiovascular Quality and Outcomes - April 29, 2015 Category: Cardiology Authors: Limdi, N. A., Thigpen, J., Ko, D., Sisson, E. K., Tripodis, G., Henault, L. E., Berger, P. B., Hylek, E. Tags: Session Title: Poster Session I Source Type: research

Improving Anticoagulation Measurement: Novel Warfarin Composite Measure Original Articles
Conclusions— WCM produces the largest range of risk for warfarin complications, widening the floor ceiling effects that limit the use of TTR and INR variability as separate measures. Anticoagulation clinics ranking changed considerably according to the anticoagulation measure that was selected.
Source: Circulation: Cardiovascular Quality and Outcomes - November 17, 2015 Category: Cardiology Authors: Razouki, Z., Burgess, J. F., Ozonoff, A., Zhao, S., Berlowitz, D., Rose, A. J. Tags: Anticoagulants, Ethics and Policy, Cerebrovascular Disease/Stroke, Thrombosis Original Articles Source Type: research

Dabigatran Versus Warfarin for Atrial Fibrillation in Real-World Clinical Practice: A Systematic Review and Meta-Analysis Original Articles
Conclusions— In real-world clinical practice, dabigatran is comparable with warfarin in preventing ischemic stroke among patients with nonvalvular atrial fibrillation. However, dabigatran is associated with a lower risk for intracranial bleeding relative to warfarin, but—particularly among the elderly—a greater risk for gastrointestinal bleeding. Bleeding outcomes from observational studies are consistent with those from the pivotal Randomized Evaluation of Long-Term Anticoagulation Therapy trial.
Source: Circulation: Cardiovascular Quality and Outcomes - March 15, 2016 Category: Cardiology Authors: Romanelli, R. J., Nolting, L., Dolginsky, M., Kym, E., Orrico, K. B. Tags: Meta Analysis, Ischemic Stroke Original Articles Source Type: research

Abstract 161: Lean Process Improvements Reduce Door to CT and Door to Needle Times for Acute Ischemic Stroke Patients Session Title: Poster Session II
Conclusions: Lean process improvement methodology significantly reduces door to CT and door to needle times, supporting current AHA Target: Stroke goals and allowing faster treatment of patients with acute ischemic stroke. Incorporating time-outs into standardized processes that aim to deliver care more quickly may improve patient safety without substantially slowing down DTN times. Further investigation is required to determine whether the new process improved safety and clinical outcomes.
Source: Circulation: Cardiovascular Quality and Outcomes - March 31, 2017 Category: Cardiology Authors: McCann, C., Tkach, A., de Havenon, A., Loosli, J., Troyer, J., Bennett, A., Wold, J., Jex, A., Majersik, J. J. Tags: Session Title: Poster Session II Source Type: research

Abstract 222: Use of a Decision Support Tool for Ischemic Stroke Treatment in a Telehealth System Session Title: Poster Session II
Conclusions: The preliminary results showed the rural hospital providers saw value in the RESOLVE tool while discussing the risks and benefits with patient/family. Future strategies would include process changes to expedite the faxing of the RESOLVE tool.
Source: Circulation: Cardiovascular Quality and Outcomes - March 31, 2017 Category: Cardiology Authors: Summers, D., Gialde, E., Spertus, J. A., Decker, C. Tags: Session Title: Poster Session II Source Type: research

Sex-Specific Comparative Effectiveness of Oral Anticoagulants in Elderly Patients With Newly Diagnosed Atrial Fibrillation Original Articles
Conclusions— The reduced risk of ischemic stroke in patients taking rivaroxaban, compared with dabigatran and warfarin, seems to be limited to men, whereas the higher risk of bleeding seems to be limited to women.
Source: Circulation: Cardiovascular Quality and Outcomes - April 13, 2017 Category: Cardiology Authors: Palamaner Subash Shantha, G., Bhave, P. D., Girotra, S., Hodgson-Zingman, D., Mazur, A., Giudici, M., Chrischilles, E., Vaughan Sarrazin, M. S. Tags: Anticoagulants, Cerebrovascular Disease/Stroke Original Articles Source Type: research

Abstract 269: Do Transferred-In Patients Have Longer Lengths of Stay at a Stroke Center? Session Title: Poster Session PM
Conclusion: While LOS for patients discharged to SNF was not significantly different between those transferred as compared to those who directly present to our CSC, discharges to ARF were significantly longer among those who were transferred to our CSC. Future efforts should be made to examine potential reasons for prolonged LOS among this group of patients.
Source: Circulation: Cardiovascular Quality and Outcomes - April 5, 2018 Category: Cardiology Authors: Asaithambi, G., Castle, A. L., Kukielka, D., Ho, B. M., Marino, E. H., Hanson, S. K. Tags: Session Title: Poster Session PM Source Type: research

Abstract 200: Cost-Effectiveness of Newer Anticoagulants for Stroke Prevention in Atrial Fibrillation Poster Session II
Conclusions: Cost-effectiveness models of newer anticoagulants for SPAF have been extensively published. Models have frequently found newer anticoagulants to be cost-effective, but due to the lack of head-to-head trial comparisons and heterogeneity in clinical characteristic of underlying trials and modeling methods, it is currently unclear which of these newer agents is most cost-effective.
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Limone, B. L., Baker, W. L., Coleman, C. I. Tags: Poster Session II Source Type: research

Abstract 232: Parenteral Antihypertensive Use on the First Day of Hospitalization after Acute Ischemic Stroke: A US Population Study Poster Session II
Conclusion: Approximately 16% of AIS patients receive IV AH medication in the first 24 hours of admission in the US. The rate of early AH treatment has increased over time both overall and among those who did not receive rt-PA. Whether this is due to increasingly aggressive BP treatment by physicians or higher BP on admission among AIS patients is unclear. Contrary to recommendations, nicardipine was used infrequently. More evidence is required to justify specific AH agents for BP treatment in AIS.
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Wang, Y., McDonough, E., Adeoye, O., LaPensee, K., Crothers, T. C., Kleindorfer, D. Tags: Poster Session II Source Type: research

Abstract 234: Prior Warfarin Treatment and Intracranial Hemorrhage among Patients With Acute Ischemic Stroke Treated With Intravenous Tissue Plasminogen Activator: A Meta-analysis Poster Session II
Conclusions: These data suggested that the risk of sICH after thrombolytic therapy is not increased in patients using warfarin with sub therapeutic INR levels.
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Li, H., Xian, Y., Laskowitz, D., Peterson, E. Tags: Poster Session II Source Type: research

Acute Stroke: Shifting From Informed Consent to Informed Refusal of Intravenous Tissue-Type Plasminogen Activator Editorial
Source: Circulation: Cardiovascular Quality and Outcomes - October 29, 2015 Category: Cardiology Authors: Schwamm, L. H. Tags: Ethics and Policy, Quality and Outcomes, Cerebrovascular Disease/Stroke, Ischemic Stroke Editorial Source Type: research

Abstract 33: Incidence Of Urinary Tract Infection Among Patients With Acute Cerebrovascular Accidents: A Possible Trigger For Stroke Poster Session I
Conclusion:Our findings provide some evidence that the incidence of UTI is significantly higher for patients with CVA than is found in the general population
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: kali, M., Kuruvilla, J., Lucas, D., Broce, M., Seybold, D., Reyes, B. Tags: Poster Session I Source Type: research

Most Important Outcomes Research Papers on Stroke and Transient Ischemic Attack Circulation: Cardiovascular Quality and Outcomes Topic Review
Source: Circulation: Cardiovascular Quality and Outcomes - January 21, 2014 Category: Cardiology Authors: Dreyer, R., Murugiah, K., Nuti, S. V., Dharmarajan, K., Chen, S. I., Chen, R., Wayda, B., Ranasinghe, I., for the Editor Tags: Other Stroke Treatment - Medical Circulation: Cardiovascular Quality and Outcomes Topic Review Source Type: research

Pace of Progress in Stroke Thrombolysis: Are Hospitals Running To Stand Still? Editorial
Source: Circulation: Cardiovascular Quality and Outcomes - January 16, 2017 Category: Cardiology Authors: Mendelson, S. J., Prabhakaran, S. Tags: Health Services, Quality and Outcomes, Ischemic Stroke Editorial Source Type: research

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