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Contemporary Trends in Oral Anticoagulant Prescription in Atrial Fibrillation Patients at Low to Moderate Risk of Stroke After Guideline-Recommended Change in Use of the CHADS2 to the CHA2DS2-VASc Score for Thromboembolic Risk Assessment: Analysis From the National Cardiovascular Data Registrys Outpatient Practice Innovation and Clinical Excellence Atrial Fibrillation Registry Original Articles
Conclusions— Adoption of the CHA2DS2-VASc score reclassifies 64.5% of patients with AF with low CHADS2 scores into a class I indication for OAC prescription. Overall OAC prescription increased between 2011 and 2014.
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2017 Category: Cardiology Authors: Katz, D. F., Maddox, T. M., Turakhia, M., Gehi, A., OBrien, E. C., Lubitz, S. A., Turchin, A., Doros, G., Lei, L., Varosy, P., Marzec, L., Hsu, J. C. Tags: Arrhythmias, Anticoagulants, Quality and Outcomes Original Articles 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 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

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

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 2: Comparative Effectiveness and Safety of Anticoagulant Therapy With Warfarin, Dabigatran, Apixaban, or Rivaroxaban in Patients With Nonvalvular Atrial Fibrillation Session Title: Abstract Oral Session: QCOR 2016 Young Investigator Awards
Conclusions: Our results demonstrated a lower risk of a thromboembolic event or stroke among dabigatran, apixaban, or rivaroxaban users compared to warfarin users. Among NOACs, risks of a thromboembolic event or stroke were similar. Further studies are needed to clarify the finding of a higher major bleeding risk in warfarin and rivaroxaban users.
Source: Circulation: Cardiovascular Quality and Outcomes - February 26, 2016 Category: Cardiology Authors: Adeboyeje, G., Sylwestrzak, G., White, J., Rosenberg, A., Abarca, J., Crawford, G., Barron, J. Tags: Session Title: Abstract Oral Session: QCOR 2016 Young Investigator Awards Source Type: research

Abstract 154: Estimating Treatment Effects in More Than Two Treatment Groups via Propensity Score Weighting: Practical Guidance and Application from Anticoagulant Therapy in Atrial Fibrillation Study Session Title: Abstract Poster Session I and Reception
Conclusions: Our results showed IPTW methods, correctly employed under certain assumptions, are practical and relatively simple tools to control for selection bias and other baseline differences in observational studies evaluating the comparative treatment effects of more than two treatment arms. When preserving sample size is important and in the presence of time-varying confounders, IPTW methods have distinct advantages over propensity matching or adjustment.
Source: Circulation: Cardiovascular Quality and Outcomes - February 26, 2016 Category: Cardiology Authors: Adeboyeje, G., Sylwestrzak, G., Barron, J. Tags: Session Title: Abstract Poster Session I and Reception Source Type: research

Sex Differences in Dabigatran Use, Safety, And Effectiveness In a Population-Based Cohort of Patients With Atrial Fibrillation Original Articles
Conclusions— In real-life practice, women are more frequently treated with low-dose dabigatran, yet a trend toward lower stroke rates in women taking high-dose dabigatran was observed. Men benefit from lower bleeding rates with dabigatran compared with warfarin.
Source: Circulation: Cardiovascular Quality and Outcomes - November 17, 2015 Category: Cardiology Authors: Avgil Tsadok, M., Jackevicius, C. A., Rahme, E., Humphries, K. H., Pilote, L. Tags: Epidemiology, Anticoagulants, Ethics and Policy Original Articles Source Type: research

Novel Oral Anticoagulant Use Among Patients With Atrial Fibrillation Hospitalized With Ischemic Stroke or Transient Ischemic Attack Original Articles
Conclusions— NOACs have had modest but growing uptake over time among atrial fibrillation patients hospitalized with stroke or transient ischemic attack and are prescribed to patients with lower stroke risk compared with warfarin.
Source: Circulation: Cardiovascular Quality and Outcomes - July 21, 2015 Category: Cardiology Authors: Patel, P. A., Zhao, X., Fonarow, G. C., Lytle, B. L., Smith, E. E., Xian, Y., Bhatt, D. L., Peterson, E. D., Schwamm, L. H., Hernandez, A. F. Tags: Other anticoagulants, Embolic stroke, Anticoagulants Original Articles Source Type: research

Abstract 150: Antithrombotic Use in Nonvalvular Atrial Fibrillation (NVAF): Alignment between Guidelines and Emerging Evidence with Clinician Prescribing Preferences Session Title: Poster Session I
Conclusions: Similar to findings from indirect treatment comparison studies, physicians largely prefer NOACs_particularly apixaban_compared to warfarin or aspirin for stroke risk reduction in NVAF patients. Additional research is needed to determine why NOACs are underused in practice.
Source: Circulation: Cardiovascular Quality and Outcomes - April 29, 2015 Category: Cardiology Authors: Shafrin, J., Bruno, A., MacEwan, J. P., Campinha-Bacote, A., Trocio, J., Tan, W., Romley, J. A. Tags: Session Title: Poster Session I Source Type: research

Abstract 152: Persistence of Warfarin versus Dabigatran Therapy in Patients with Atrial Fibrillation: Results from the ORBIT AF Registry Session Title: Poster Session I
Conclusion: Persistence rates for warfarin were higher at one year than those on dabigatran. In addition, factors associated with persistence of warfarin include: African American and Hispanic race, type of AF including permanent and persistent, LVH, and CHA2DS2-VASc risk scores ≥ 2.
Source: Circulation: Cardiovascular Quality and Outcomes - April 29, 2015 Category: Cardiology Authors: Jackson, L. R., Kim, S., Shrader, P., Blanco, R., Thomas, L., Ansell, J., Fonarow, G. C., Gersh, B. J., Go, A. S., Kowey, P., Mahaffey, K. W., Hylek, E. M., Burton, P., Peterson, E. D., Piccini, J. P. Tags: Session Title: Poster Session I Source Type: research

Abstract 157: An Early Assessment of Hospital Readmissions Among Nonvalvular Atrial Fibrillation Treated with the New Oral Anticoagulants, Apixaban, Dabigatran, and Rivaroxaban Session Title: Poster Session I
Conclusion: In this early assessment, treatment with rivaroxaban vs. apixaban was associated with greater risk of all-cause or bleeding-related 1-month readmissions and higher hospital costs due to readmissions.
Source: Circulation: Cardiovascular Quality and Outcomes - April 29, 2015 Category: Cardiology Authors: Deitelzweig, S., Bruno, A., Trocio, J., Tate, N., Lin, J., Lingohr-Smith, M. Tags: Session Title: Poster Session I Source Type: research

Abstract 339: Hospitalization Rates and Healthcare Costs Among Non-valvular Atrial Fibrillation Patients Who Were Naive Users of Novel Oral Anticoagulants Session Title: Poster Session III
Conclusions: This early assessment shows that among anticoagulant naïve NVAF patients, treatment with apixaban was associated with a lower rate of all-cause hospitalization, as well as lower overall costs compared to other NOACs. Further evaluation is needed to provide additional detail on potential drivers of utilization differences.
Source: Circulation: Cardiovascular Quality and Outcomes - April 29, 2015 Category: Cardiology Authors: Deitelzweig, S., Bruno, A., Tate, N., Ogbonnaya, A., Shah, M., Farrelly, E., Lokhandwala, T., Gupta, K., Eaddy, M. Tags: Session Title: Poster Session III Source Type: research

Abstract 14: Clinical Characteristics and Treatment Patterns of Medicaid Patients with Atrial Fibrillation: Insights From the ORBIT-AF I Registry Session Title: Concurrent Session IIB: Oral Abstracts - Quality of Care
Conclusions: In a contemporary, community-based AF cohort, Medicaid patients had a greater comorbidity burden and higher stroke risk, yet were less likely to receive OAC compared with those with other forms of insurance.
Source: Circulation: Cardiovascular Quality and Outcomes - April 29, 2015 Category: Cardiology Authors: O'Brien, E. C., Kim, S., Thomas, L., Fonarow, G. C., Mahaffey, K. W., Kowey, P. R., Gersh, B. J., Burton, P. S., Piccini, J. P., Peterson, E. D. Tags: Session Title: Concurrent Session IIB: Oral Abstracts - Quality of Care Source Type: research

Abstract 161: Atrial Fibrillation in India: Insights from the PINNACLE India Outpatient Registry Session Title: Poster Session I
Conclusion: AF is tough to diagnose since it is often asymptomatic and clinicians need many tests to confirm diagnosis. Lack of documentation or detection of AF and its associated conditions is a concern. AF can lead to life threatening problems such as stroke and heart failure. The surveillance of AF in India is important in order to identify opportunities for intervention. Continued data collection through the use of a cardiovascular registry can improve the understanding of AF in India.
Source: Circulation: Cardiovascular Quality and Outcomes - June 2, 2014 Category: Cardiology Authors: Glusenkamp, N. T., Risch, S. A., Kerkar, P., Kumar, G., Oetgen, W. J. Tags: Session Title: Poster Session I Source Type: research

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