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Abstract 159: Evaluation of Clinical Outcomes among Nonvalvular Atrial Fibrillation Patients Treated With Warfarin or Rivaroxaban Stratified by Presence or Absence of CKD in a Claims Database Session Title: Poster Session II
Conclusions: This study suggests that, in an adult population with NVAF, rivaroxaban-treated patients had fewer ischemic strokes across all patients, including patients with renal impairment. Rivaroxaban-treated patients also had significantly better outcomes for the composite (VTE, MI, or stroke) measure across all groups. Bleeding rates were comparable across all groups.
Source: Circulation: Cardiovascular Quality and Outcomes - March 31, 2017 Category: Cardiology Authors: Weir, M. R., Haskell, L., Berger, J. S., Ashton, V., Laliberte, F., Crivera, C., Brown, K., Lefebvre, P., Schein, J. Tags: Session Title: Poster Session II Source Type: research

Abstract 160: Impact of Medication Adherence on Risk of Stroke, Major Bleeding and Other Outcomes in Atrial Fibrillation Patients Using Novel Oral Anticoagulants (Dabigatran and Rivaroxaban) Session Title: Poster Session II
Conclusion: In our sample, adherence to NOACs was associated with a reduction in stroke and DVTPE risk but did not substantially increase bleeding risk. Further studies with newer NOACs are warranted.
Source: Circulation: Cardiovascular Quality and Outcomes - March 31, 2017 Category: Cardiology Authors: Deshpande, C. G., Willey Temkin, C., Laforge, R., Kogut, S. Tags: Session Title: Poster Session II Source Type: research

Long-Term Persistence of Newly Initiated Warfarin Therapy in Chinese Patients With Nonvalvular Atrial Fibrillation Original Articles
Conclusions— Nonpersistence of warfarin treatment becomes a serious problem for stroke prevention in Chinese patients with nonvalvular AF. Our findings can be used to identify patients who require closer attention or to develop better management strategy for oral anticoagulation therapy.
Source: Circulation: Cardiovascular Quality and Outcomes - July 18, 2016 Category: Cardiology Authors: Wang, Z.-Z., Du, X., Wang, W., Tang, R.-B., Luo, J.-G., Li, C., Chang, S.-S., Liu, X.-H., Sang, C.-H., Yu, R.-H., Long, D.-Y., Wu, J.-H., Bai, R., Liu, N., Ruan, Y.-F., Dong, J.-Z., Ma, C.-S. Tags: Atrial Fibrillation, Compliance/Adherence, Treatment Original Articles Source Type: research

Safety and Use of Anticoagulation After Aortic Valve Replacement With Bioprostheses: A Meta-Analysis Original Articles
Conclusions— Contrary to the current guidelines, a meta-analysis of previous studies suggests that anticoagulation in the setting of an aortic bioprosthesis significantly increases bleeding risk without a favorable effect on thromboembolic events. Larger, randomized controlled studies should be performed to further guide this clinical practice.
Source: Circulation: Cardiovascular Quality and Outcomes - May 16, 2016 Category: Cardiology Authors: Riaz, H., Alansari, S. A. R., Khan, M. S., Riaz, T., Raza, S., Luni, F. K., Khan, A. R., Riaz, I. B., Krasuski, R. A. Tags: Anticoagulants, Aortic Valve Replacement/Transcatheter Aortic Valve Implantation Original Articles Source Type: research

Reimagining Anticoagulation Clinics in the Era of Direct Oral Anticoagulants Cardiovascular Perspective
Anticoagulation clinics were initially developed to provide safe and effective care for warfarin-treated patients with atrial fibrillation, venous thromboembolism, and mechanical valve replacement. Traditionally, these patients required ongoing laboratory monitoring and warfarin dose adjustment by expert providers. With the introduction of direct oral anticoagulants (dabigatran, rivaroxaban, apixaban, and edoxaban), many have questioned the need for anticoagulation clinic. However, we think that the growing number of oral anticoagulant choices creates an urgent need for expanding the traditional role of the anticoagulation...
Source: Circulation: Cardiovascular Quality and Outcomes - March 15, 2016 Category: Cardiology Authors: Barnes, G. D., Nallamothu, B. K., Sales, A. E., Froehlich, J. B. Tags: Atrial Fibrillation, Ethics and Policy, Health Services, Ischemic Stroke, Thrombosis Cardiovascular Perspective Source Type: research

Abstract 201: Are Patients With Atrial Fibrillation Willing to Consider New Strategies to Prevent Stroke? A Qualitative Analysis of Community-Based Focus Groups Session Title: Abstract Poster Session II
Conclusion: Focus group participants expressed a fear of debilitating stroke, with varying levels of acceptance of inconveniences and potential bleeding associated with blood thinners. Among a subset of participants, there was willingness to consider new stroke prevention therapies; however, this was preferred with a known, trusted physician. Subspecialized clinicians offering new therapies may be challenged to establish perceived mutual respect with patients, traditionally built over time, and this may be required for patients to consider new therapies. Future research is needed to determine best practices for both establ...
Source: Circulation: Cardiovascular Quality and Outcomes - February 26, 2016 Category: Cardiology Authors: ONeill, E. S., Grande, S. W., Coylewright, M. Tags: Session Title: Abstract Poster Session II 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

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

Integrating Real-Time Clinical Information to Provide Estimates of Net Clinical Benefit of Antithrombotic Therapy for Patients With Atrial Fibrillation Original Articles
Conclusions— Use of a decision support tool that integrates patient-specific stroke and bleeding risk could result in significant gains in quality-adjusted life expectancy for a primary care population of patients with atrial fibrillation.
Source: Circulation: Cardiovascular Quality and Outcomes - September 16, 2014 Category: Cardiology Authors: Eckman, M. H., Wise, R. E., Speer, B., Sullivan, M., Walker, N., Lip, G. Y. H., Kissela, B., Flaherty, M. L., Kleindorfer, D., Khan, F., Kues, J., Baker, P., Ireton, R., Hoskins, D., Harnett, B. M., Aguilar, C., Leonard, A., Prakash, R., Arduser, L., Cost Tags: Health policy and outcome research, Primary prevention, Coumarins, Thrombosis risk factors, Arrhythmias, clinical electrophysiology, drugs, Anticoagulants, Epidemiology Original Articles Source Type: research

Abstract 264: Assessing Thromboembolic Risk In Patients Undergoing Direct Electrical Cardioversion Within 48 Hours After Onset Of Atrial Fibrillation Session Title: Poster Session II
Conclusions In patients with acute onset atrial fibrillation, odds of thromboembolic complications are over 5 times higher in patients who did not receive therapeutic anti-coagulation at the time of DCC, despite having a lower baseline stroke risk as defined by their CHA2DS2-VASc scores. In addition, the two patients in our study who did have a stroke in the therapeutically anti-coagulated group had ceased their anticoagulant prior to the stroke.
Source: Circulation: Cardiovascular Quality and Outcomes - June 2, 2014 Category: Cardiology Authors: Garg, A., Khunger, M., Seicean, S., Chung, M., Tchou, P. Tags: Session Title: Poster Session II Source Type: research

Abstract 156: Body Mass Index and Outcomes among Patients with Atrial Fibrillation from the ATRIA2-CVRN Study Poster Session II
In conclusion, overweight and moderate obesity appear protective for all-cause mortality in at-risk AF patients during off-warfarin periods, but these effects do not appear to be mediated by reduced risk of thromboembolism or major bleeding.
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Black, M. H., Wu, J., Singer, D. E., Udaltsova, N., Harrison, T. N., Shen, A. Y.-J., Fang, M. C., Go, A. S., Reynolds, K. 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

Abstract 258: Dabigatran Etexilate is Associated with Shorter Hospital Length of Stay and Lower Hospital Costs Compared to Warfarin in Treatment-Naive, Newly-Diagnosed Nonvalvular Atrial Fibrillation Patients Poster Session III
Conclusions: Among hospitalizations of treatment-naive patients newly diagnosed with nonvalvular AF, the hospitalizations during which DE was administered had a shorter LOS and at least a 12% lower total hospital cost compared to hospitalizations where warfarin was administered.
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Fonseca, E., Walker, D. R., Hess, G. P. Tags: Poster Session III Source Type: research