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Patterns of Emergency Medical Services Use and Its Association With Timely Stroke Treatment: Findings From Get With the Guidelines-Stroke Original Articles
Conclusions— Although EMS use is independently associated with more rapid evaluation and treatment of stroke, more than one third of stroke patients fail to use EMSs. Interventions aimed at increasing EMS activation should target populations at risk, particularly younger patients and those of minority race and ethnicity.
Source: Circulation: Cardiovascular Quality and Outcomes - May 21, 2013 Category: Cardiology Authors: Ekundayo, O. J., Saver, J. L., Fonarow, G. C., Schwamm, L. H., Xian, Y., Zhao, X., Hernandez, A. F., Peterson, E. D., Cheng, E. M. Tags: Emergency treatment of Stroke Original Articles Source Type: research

Atrial Fibrillation, Stroke, and Anticoagulation in Medicare Beneficiaries: Trends by Age, Sex, and Race, 1992-2010 Stroke
Conclusions Ischemic stroke rates among Medicare AF patients decreased significantly in all demographic subpopulations from 1992–2010, coincident with increasing warfarin use. Ischemic stroke rates remained higher and warfarin use rates remained lower for women and blacks with AF, groups whose baseline CHADS scores were higher.
Source: JAHA:Journal of the American Heart Association - June 3, 2014 Category: Cardiology Authors: Shroff, G. R., Solid, C. A., Herzog, C. A. Tags: Stroke Source Type: research

Abstract 223: National and Regional Trends in Hospitalizations for Hemorrhagic Stroke after Acute Myocardial Infarction in the United States: 1999-2010 Poster Session II
Conclusions: From 1999 to 2010, the overall hospitalization rates of hemorrhagic stroke after AMI were relatively stable without significant changes across all subgroups. Thirty-day mortality rates remained largely unchanged over time. Stroke risk in the stroke belt was not found significantly higher comparing with non-stroke belt states.
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Shi, R., Wang, Y., Lichtman, J. H., Dharmarajan, K., Masoudi, F. A., Dodson, J. A., Chen, J., Chaudhry, S. I., Spertus, J. A., Nallamothu, B. K., Krumholz, H. M. Tags: Poster Session II Source Type: research

Abstract 301: Healthcare Costs Following Stroke and Major Bleeding Events in Nonvalvular Atrial Fibrillation Patients Session Title: Poster Session III
Conclusions: NVAF patients who have a stroke or MB event incur higher healthcare costs relative to patients without events. Interventions preventing stroke or MB events have the potential to reduce the healthcare burden associated NVAF.
Source: Circulation: Cardiovascular Quality and Outcomes - April 29, 2015 Category: Cardiology Authors: Naccarelli, G., Stokes, M., DeLeon, A., Tate, N., Wang, R., Wang, A., Fredell, J. Tags: Session Title: Poster Session III Source Type: research

National trends in stroke after acute myocardial infarction among Medicare patients in the United States: 1999 to 2010
Conclusions From 1999 to 2010, the 1-year risk for ischemic stroke after AMI declined, whereas the risk of hemorrhagic stroke remained unchanged. However, 30-day and 1-year mortality continued to be high.
Source: American Heart Journal - December 9, 2014 Category: Cardiology Source Type: research

Abstract 233: Trends in Referral to Post-Acute Care Services after an Acute Stroke Hospitalization in the U.S.: Findings from the Get With The Guidelines-Stroke Program Poster Session II
Conclusions: Since 2003 there was a slight increase in the proportion of stroke patients discharged to post-acute care among hospitals participating in GWTG-Stroke. However, 4 in 10 patients are discharged home without services. Over the last decade of payment reform, there has been modest change in types but not the overall referral to post-acute services for stroke patients.
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Prvu Bettger, J., McCoy, L., Smith, E. E., Fonarow, G. C., Schwamm, L. H., Peterson, E. D. Tags: Poster Session II Source Type: research

Clinical Effectiveness of Statin Therapy after Ischemic Stroke: Primary Results from the Statin Therapeutic Area of the Patient-Centered Research into Outcomes Stroke Patients Prefer and Effectiveness Research (PROSPER) Study.
CONCLUSIONS: -In older ischemic stroke patients who were not taking statins at the time of admission, discharge statin therapy was associated with lower risk of MACE and nearly a month more home-time during the 2-year period post-hospitalization. PMID: 26246175 [PubMed - as supplied by publisher]
Source: Circulation - August 5, 2015 Category: Cardiology Authors: O'Brien EC, Greiner MA, Xian Y, Fonarow GC, Olson DM, Schwamm LH, Bhatt DL, Smith EE, Maisch L, Hannah D, Lindholm B, Peterson ED, Pencina MJ, Hernandez AF Tags: Circulation Source Type: research

Validity of Claims-Based Stroke Algorithms in Contemporary Medicare Data: Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study Linked With Medicare Claims Methods Paper
Conclusions— Claims-based algorithms to identify stroke in a contemporary Medicare cohort had high positive predictive value and specificity, supporting their use as outcomes for etiologic and comparative effectiveness studies in similar populations. These inpatient algorithms are unsuitable for estimating stroke incidence because of low sensitivity.
Source: Circulation: Cardiovascular Quality and Outcomes - July 15, 2014 Category: Cardiology Authors: Kumamaru, H., Judd, S. E., Curtis, J. R., Ramachandran, R., Hardy, N. C., Rhodes, J. D., Safford, M. M., Kissela, B. M., Howard, G., Jalbert, J. J., Brott, T. G., Setoguchi, S. Tags: Health policy and outcome research, Acute Cerebral Hemorrhage, Acute Cerebral Infarction Methods Paper Source Type: research

Clinical course of atrial fibrillation in older adults: the importance of cardiovascular events beyond stroke
Conclusion After the diagnosis of incident atrial fibrillation in older adults, mortality was the most frequent major outcome during the first 5 years. Among non-fatal cardiovascular events, heart failure was the most common event.
Source: European Heart Journal - January 21, 2014 Category: Cardiology Authors: Piccini, J. P., Hammill, B. G., Sinner, M. F., Hernandez, A. F., Walkey, A. J., Benjamin, E. J., Curtis, L. H., Heckbert, S. R. Tags: Atrial fibrillation Source Type: research

Functional Disability and Cognitive Impairment After Hospitalization for Myocardial Infarction and Stroke Original Articles
Conclusions— In this population-based cohort, most MI and stroke hospitalizations were associated with significant increases in functional disability at the time of the event and in the decade afterward. Survivors of MI and stroke warrant screening for functional disability over the long-term.
Source: Circulation: Cardiovascular Quality and Outcomes - November 18, 2014 Category: Cardiology Authors: Levine, D. A., Davydow, D. S., Hough, C. L., Langa, K. M., Rogers, M. A. M., Iwashyna, T. J. Tags: Health policy and outcome research, Acute myocardial infarction, Acute Cerebral Hemorrhage, Acute Cerebral Infarction, Epidemiology Original Articles Source Type: research

Effectiveness and Safety of Restarting Oral Anticoagulation in Patients with Atrial Fibrillation after an Intracranial Hemorrhage: Analysis of Medicare Part D Claims Data from 2010 –2016
ConclusionsIn AF patients who survived an ICH, restarting OAC was not associated with a greater risk of recurrent ICH. Evidence from randomized controlled studies is needed to further clarify the clinical benefit of restarting OAC in this high-risk population. Further evaluation of which individuals benefit from restarting OAC is also needed to provide more clinical guidance.
Source: American Journal of Cardiovascular Drugs - December 5, 2019 Category: Cardiology Source Type: research

Effectiveness and Safety of Dabigatran and Warfarin in Real-World US Patients With Non-Valvular Atrial Fibrillation: A Retrospective Cohort Study Health Services and Outcomes Research
Conclusions Dabigatran could be a safe and potentially more effective alternative to warfarin in patients with atrial fibrillation managed in routine practice settings.
Source: JAHA:Journal of the American Heart Association - April 10, 2015 Category: Cardiology Authors: Lauffenburger, J. C., Farley, J. F., Gehi, A. K., Rhoney, D. H., Brookhart, M. A., Fang, G. Tags: Health Services and Outcomes Research Source Type: research

Cardiovascular, Bleeding, and Mortality Risks in Elderly Medicare Patients Treated with Dabigatran or Warfarin for Non-Valvular Atrial Fibrillation.
CONCLUSIONS: -In general practice settings, dabigatran was associated with reduced risk of ischemic stroke, intracranial hemorrhage, and death, and increased risk of major gastrointestinal hemorrhage compared with warfarin in elderly patients with non-valvular AF. These associations were most pronounced in patients treated with dabigatran 150 mg twice daily, whereas the association of 75 mg twice daily with study outcomes was indistinguishable from warfarin except for a lower risk of intracranial hemorrhage with dabigatran. PMID: 25359164 [PubMed - as supplied by publisher]
Source: Circulation - October 30, 2014 Category: Cardiology Authors: Graham DJ, Reichman ME, Wernecke M, Zhang R, Southworth MR, Levenson M, Sheu TC, Mott K, Goulding MR, Houstoun M, MaCurdy TE, Worrall C, Kelman JA Tags: Circulation Source Type: research

Abstract 072: Impact of Chronic Diabetes on Periprocedural Outcomes Among Patient With Atrial Fibrillation and Flutter Who Underwent Radiofrequency Catheter Ablation Therapy (RFA). Report From the NIS 2014. Session Title: Poster Session I
Conclusions: RFA has a similar procedural safety in diabetics when compared to non-diabetic patients. It remains a safe procedure in diabetics with drug-refractory atrial fibrillation and flutter. Renal failure, CHF, type of Insurance, hospital location and teaching status are predictors of complications after RFA.
Source: Circulation: Cardiovascular Quality and Outcomes - March 31, 2017 Category: Cardiology Authors: Alliu, S. E., Adejumo, A., Durojaiye, M., Emmanuel, A., Wolf, L., Lichstein, E., Hecht, M., Stephan, K., Adegbala, O., Onyeakusi, N., Ajayi, T. Tags: Session Title: Poster Session I Source Type: research

Comparative effectiveness and safety between non-VKA oral anticoagulants in non-valvular atrial fibrillation patients: A dose subgroup analysis of the ARISTOPHANES Study
ConclusionsAmong NVAF pts, both standard- and lower-dose api pts had lower rates of MB compared to corresponding doses of dabi and riva, respectively; both doses of api demonstrated lower rates of S/SE vs. corresponding doses of riva. The comparisons between dabi and riva showed varying results for S/SE and MB across dosage levels. Dose selection criteria cannot be ascertained from the current data sources. Future studies of pts who were appropriately dosed are warranted.
Source: Archives of Cardiovascular Diseases Supplements - December 25, 2018 Category: Cardiology Source Type: research

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