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Outcome disparities in patients with atrial fibrillation based on insurance plan and educational attainment: a nationwide, multicenter and prospective cohort trial
Conclusion Educational attainment was independently associated with all-cause mortality and ischaemic stroke in patients with AF, but adverse clinical outcomes were not related to the types of health insurance in Thailand. Trial registration number Thai Clinical Trial Registration; Study ID: TCTR20160113002.
Source: BMJ Open - August 10, 2022 Category: General Medicine Authors: Apiyasawat, S., Thongsri, T., Jongpiputvanich, K., Krittayaphong, R., for the COOL-AF Investigators Tags: Open access, Cardiovascular medicine Source Type: research

Prospective randomised trial examining the impact of an educational intervention versus usual care on anticoagulation therapy control based on an SAMe-TT2R2 score-guided strategy in anticoagulant-naïve Thai patients with atrial fibrillation (TREATS-AF): a study protocol
Introduction The burden of atrial fibrillation (AF) in Thailand is high and associated with increased morbidity, mortality and healthcare costs. Vitamin K antagonists (eg, warfarin), commonly used for stroke prevention in patients with AF in Thailand, are effective but are often suboptimally controlled. We aim to evaluate the impact of an SAMe-TT2R2 score-guided strategy and educational intervention compared to usual care on anticoagulation control expressed by the time in therapeutic range (TTR) at 12 months, in anticoagulant-naïve Thai patients with AF. Methods and analysis Multicentre, open-label, parallel-grou...
Source: BMJ Open - October 11, 2021 Category: General Medicine Authors: Phrommintikul, A., Nathisuwan, S., Gunaparn, S., Krittayaphong, R., Wongcharoen, W., Sehmi, S., Mehta, S., Winkles, N., Brocklehurst, P., Mathers, J., Jowett, S., Jolly, K., Lane, D., Thomas, G. N., Lip, G. Y. H., TREATS-AF Study Group, Prasertwitayakij, Tags: Open access, Medical management Source Type: research

Stroke management in a Swiss community hospital - in close collaboration with a stroke centre
CONCLUSION: Our findings support further education of the population in recognition of stroke symptoms and assessment of cardiovascular risk factors according to guidelines. Telemedical cooperation with a local stroke centre can result in adequate quality of care in these patients.PMID:34098584 | DOI:10.4414/smw.2021.20490
Source: Swiss Medical Weekly - June 7, 2021 Category: General Medicine Authors: Rolf Erlebach Esther B ächli Esther Gerrits Mich èle Hess Source Type: research

Association between use of amiodarone for non-valvular atrial fibrillation and patient survival: from the prospective China Atrial Fibrillation Registry.
CONCLUSIONS: Our study indicated that amiodarone use was not significantly associated with a lower risk of 1-year all-cause mortality compared with a non-AAD strategy in "real-world" patients with NVAF. PMID: 33273373 [PubMed - as supplied by publisher]
Source: Chinese Medical Journal - December 1, 2020 Category: General Medicine Authors: Hou XX, He L, Du X, Wang GH, Dong JZ, Ma CS Tags: Chin Med J (Engl) Source Type: research

Effectiveness of polypill for primary and secondary prevention of cardiovascular diseases (PolyIran): a pragmatic, cluster-randomised trial
Publication date: 24–30 August 2019Source: The Lancet, Volume 394, Issue 10199Author(s): Gholamreza Roshandel, Masoud Khoshnia, Hossein Poustchi, Karla Hemming, Farin Kamangar, Abdolsamad Gharavi, Mohammad Reza Ostovaneh, Alireza Nateghi, Masoud Majed, Behrooz Navabakhsh, Shahin Merat, Akram Pourshams, Mahdi Nalini, Fatemeh Malekzadeh, Masoumeh Sadeghi, Noushin Mohammadifard, Nizal Sarrafzadegan, Mohammad Naemi-Tabiei, Abdolreza Fazel, Paul BrennanSummaryBackgroundA fixed-dose combination therapy (polypill strategy) has been proposed as an approach to reduce the burden of cardiovascular disease, especially in low-income ...
Source: The Lancet - August 23, 2019 Category: General Medicine Source Type: research

Educational and behavioural interventions for anticoagulant therapy in patients with atrial fibrillation.
CONCLUSIONS: This review demonstrates that there is insufficient evidence to draw definitive conclusions regarding the impact of educational or behavioural interventions on TTR in AF patients receiving OAT. Thus, more trials are needed to examine the impact of interventions on anticoagulation control in AF patients and the mechanisms by which they are successful. It is also important to explore the psychological implications for patients suffering from this long-term chronic condition. PMID: 28378924 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - April 5, 2017 Category: Journals (General) Authors: Clarkesmith DE, Pattison HM, Khaing PH, Lane DA Tags: Cochrane Database Syst Rev Source Type: research

Association of the 2011 ACGME Resident Duty Hour Reforms With Mortality and Readmissions Among Hospitalized Medicare Patients
Conclusions and RelevanceAmong Medicare beneficiaries, there were no significant differences in the change in 30-day mortality rates or 30-day all-cause readmission rates for those hospitalized in more intensive relative to less intensive teaching hospitals in the year after implementation of the 2011 ACGME duty hour reforms compared with those hospitalized in the 2 years before implementation.
Source: JAMA - December 10, 2014 Category: Journals (General) Source Type: research

AFib in Special Populations
Abstract: For physicians who see and treat patients who present with AFib in routine clinical practice there are 4 important factors to understand and bear in mind when diagnosing and planning treatment strategies: age, gender, prior or incident heart failure, and underlying coronary artery disease (CAD) and acute coronary syndrome (ACS). (online video available at: http://education.amjmed.com/video.php?event_id=445&stage_id=5&vcs=1). This review addresses the clinical characteristics of each of these presentations in order. For all patients with AFib, of either gender or any age, the greatest risk is failure to prescrib...
Source: The American Journal of Medicine - March 24, 2014 Category: Journals (General) Authors: William J. French Tags: CME multimedia activities Source Type: research

AFib Treatment: General Population
Abstract: When primary care physicians are presented with a patient with atrial fibrillation (AFib), there are two concerns. (online video available at: http://education.amjmed.com/video.php?event_id=445&stage_id=5&vcs=1). One is the choice of strategy to treat the AFib, ie, whether to use rate control or a rhythm control strategy (to keep patients in sinus rhythm). The second concern is preventing the principal risk associated with AFib: stroke and systemic embolism. The focus of this review is stroke prevention, concentrating on risk assessment and traditional versus the new oral anticoagulation agents. For the past se...
Source: The American Journal of Medicine - March 24, 2014 Category: Journals (General) Authors: Steven A. Rothman Tags: CME multimedia activities Source Type: research

Novel Oral Anticoagulants
Abstract: Warfarin has a proven record as an oral anticoagulant; almost every study, however, has found that it is not prescribed for 40–60% of patients who are eligible and should receive it, and of those who do receive it, serum warfarin levels only achieved a time in therapeutic range (TTR) equal to INR 2–3 about 55–60% of the time (online video available at: http://education.amjmed.com/video.php?event_id=445&stage_id=5&vcs=1). This means that only about 1 in 4 patients are adequately anticoagulated with warfarin, and thus there is a large unmet need for achieving better anticoagulation in these patients. Although...
Source: The American Journal of Medicine - March 24, 2014 Category: Journals (General) Authors: James A. Reiffel Tags: CME multimedia activities Source Type: research