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Clinical decision support for stroke prevention in atrial fibrillation (CDS-AF): Rationale and design of a cluster randomized trial in the primary care setting
Conclusion The present study will investigate whether a clinical decision support system integrated in an EHR can increase adherence to guidelines regarding anticoagulant therapy in patients with AF. Trial registration www.clinicaltrials.gov registration number NCT02635685
Source: American Heart Journal - February 15, 2017 Category: Cardiology Source Type: research

Development and Validation of Electronic Quality Measures to Assess Care for Patients With Transient Ischemic Attack and Minor Ischemic Stroke Original Articles
Conclusions— It is feasible to construct valid eQMs for processes of transient ischemic attack and minor ischemic stroke care. Healthcare systems with EHRs should consider using electronic data to evaluate care for their patients with transient ischemic attack and to complement and expand quality measurement programs currently focused on patients with stroke.
Source: Circulation: Cardiovascular Quality and Outcomes - September 14, 2017 Category: Cardiology Authors: Bravata, D. M., Myers, L. J., Cheng, E., Reeves, M., Baye, F., Yu, Z., Damush, T., Miech, E. J., Sico, J., Phipps, M., Zillich, A., Johanning, J., Chaturvedi, S., Austin, C., Ferguson, J., Maryfield, B., Snow, K., Ofner, S., Graham, G., Rhude, R., William Tags: Quality and Outcomes, Transient Ischemic Attack (TIA) Original Articles Source Type: research

Stroke Risk as a Function of Atrial Fibrillation Duration and CHA2DS2-VASc Score.
Conclusions: There is an interaction between AF duration and CHA2DS2-VASc score which can further risk stratify AF patients for SSE and may be useful in guiding anticoagulation therapy. PMID: 31564126 [PubMed - as supplied by publisher]
Source: Circulation - September 29, 2019 Category: Cardiology Authors: Kaplan RM, Koehler J, Ziegler PD, Sarkar S, Zweibel S, Passman RS Tags: Circulation Source Type: research

Net clinical benefit of warfarin in individuals with atrial fibrillation across stroke risk and across primary and secondary care
Conclusions CHA2DS2-VASc accurately stratifies IS risk in individuals with AF across both primary and secondary care. However, the incidence rate of ischaemic stroke at CHA2DS2-VASc=1 are lower than previously reported, which may change the decision to start anticoagulation with warfarin in these individuals.
Source: Heart - January 12, 2017 Category: Cardiology Authors: Allan, V., Banerjee, A., Shah, A. D., Patel, R., Denaxas, S., Casas, J.-P., Hemingway, H. Tags: Open access, Drugs: cardiovascular system, Epidemiology Arrhythmias and sudden death Source Type: research

Can a best practice advisory improve anticoagulation prescribing to reduce stroke risk in patients with atrial fibrillation?
CONCLUSIONS: A BPA added to an AF decision support tool improved anticoagulation therapy among AF patients in a primary care academic health system setting.PMID:37579873 | DOI:10.1016/j.jjcc.2023.08.005
Source: Journal of Cardiology - August 14, 2023 Category: Cardiology Authors: Mark H Eckman Ruth Wise Carol Knochelmann Rachael Mardis Anthony C Leonard Sharon Wright Ashish Gummadi Estrelita Dixon Richard C Becker Daniel P Schauer Matthew L Flaherty Alexandru Costea Dawn Kleindorfer Rob Ireton Pete Baker Brett M Harnett Adeboye Ad Source Type: research

Prediction of incident atrial fibrillation in community-based electronic health records: a systematic review with meta-analysis
Conclusions Models externally validated for prediction of incident AF in community-based EHR demonstrate moderate predictive ability and high risk of bias. Novel methods may provide stronger discriminative performance. Systematic review registration PROSPERO CRD42021245093.
Source: Heart - June 10, 2022 Category: Cardiology Authors: Nadarajah, R., Alsaeed, E., Hurdus, B., Aktaa, S., Hogg, D., Bates, M. G. D., Cowan, C., Wu, J., Gale, C. P. Tags: Open access Arrhythmias and sudden death Source Type: research

Associations of Apixaban Dose With Safety and Effectiveness Outcomes in Patients With Atrial Fibrillation and Severe Chronic Kidney Disease
CONCLUSIONS: Compared with 2.5 mg, use of 5 mg apixaban was associated with a higher risk of bleeding in patients with atrial fibrillation and severe chronic kidney disease, with no difference in the risk of stroke/systemic embolism or death, supporting the apixaban dosing recommendations on the basis of kidney function by the European Medicines Agency, which differ from those issued by the US Food and Drug Administration.PMID:37681341 | DOI:10.1161/CIRCULATIONAHA.123.065614
Source: Circulation - September 8, 2023 Category: Cardiology Authors: Yunwen Xu Alex R Chang Lesley A Inker Mara McAdams-DeMarco Morgan E Grams Jung-Im Shin 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 374: Quality Improvement Program to Optimize Pre-Operative Evaluation of Elective Cardiovascular Surgery Patients Reduces Complications and Improves Length of Stay Session Title: Poster Session III
Conclusions: A standardized pre-operative evaluation protocol in combination with prophylactic amiodarone in appropriate patients was associated with lower overall complications and a reduction in post-operative AF and LOS. Standardized protocols may enable health care providers to optimize pre-operative management of elective surgery patients and improve care quality and outcomes.
Source: Circulation: Cardiovascular Quality and Outcomes - June 2, 2014 Category: Cardiology Authors: Porten, B. R., Strauss, C. E., Mueller, J. J., Garberich, R. F., Sun, B. C., Abdelhadi, R. H., Henry, T. D. Tags: Session Title: Poster Session III Source Type: research

EP News: Clinical
Singer et  al (JAMA Cardiol 2021;6:1364, PMID 34586356) evaluated the temporal association between episodes of atrial fibrillation (AF) and stroke in patients with cardiac implantable electronic devices (CIEDs). In a case-crossover study, data from an electronic health record database were linked with record s of patients with CIEDs. The prespecified duration of AF was ≥5.5 hours during days 1–30 vs days 91–120 prestroke. The main outcome was odds ratio (OR) for stroke comparing AF during days 1–30 vs days 91–120 prestroke.
Source: Heart Rhythm - February 2, 2022 Category: Cardiology Authors: N.A. Mark Estes Tags: EP NEWS Source Type: research

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