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Automated Software System to Promote Anticoagulation and Reduce Stroke Risk Brief Report
Conclusions—No significant change in OAC prescribing occurred. A greater rate of diagnosis of transient ischemic attack (possibly because of improved detection or overdiagnosis) was associated with a reduction (of borderline significance) in stroke and hemorrhage over 12 months.Clinical Trial Registration—URL: http://www.isrctn.com. Unique Identifier: ISRCTN55722437.
Source: Stroke - February 26, 2017 Category: Neurology Authors: Tim A. Holt, Andrew Dalton, Tom Marshall, Matthew Fay, Nadeem Qureshi, Susan Kirkpatrick, Jenny Hislop, Daniel Lasserson, Karen Kearley, Jill Mollison, Ly-Mee Yu, F.D. Richard Hobbs, David Fitzmaurice Tags: Atrial Fibrillation, Anticoagulants, Health Services, Ischemic Stroke Brief Reports Source Type: research

Disparities in the Use of Seizure Medications After Intracerebral Hemorrhage Brief Report
Background and Purpose—We investigated potential disparities in the use of prophylactic seizure medications in patients with intracerebral hemorrhage.Methods—Review of multicenter electronic health record (EHR) data with simultaneous prospective data recording. EHR data were retrieved from HealthLNK, a multicenter EHR repository in Chicago, Illinois, from 2006 to 2012 (multicenter cohort). Additional data were prospectively coded (single-center cohort) from 2007 through 2015.Results—The multicenter cohort comprised 3422 patients from 4 HealthLNK centers. Use of levetiracetam varied by race/ethnicity (P=0.0000008), wi...
Source: Stroke - February 26, 2017 Category: Neurology Authors: Andrew M. Naidech, Paloma Toledo, Shyam Prabhakaran, Jane L. Holl Tags: Health Services, Intracranial Hemorrhage Brief Reports 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

Usual blood pressure, atrial fibrillation and vascular risk: evidence from 4.3 million adults
Conclusions:</strong> The association between elevated blood pressure and AF attenuates with increasing age. AF without antithrombotic usage is associated with an increased risk of eight vascular events.</span>
Source: International Journal of Epidemiology - April 28, 2016 Category: Epidemiology Source Type: research

Palliative Care Consultation Did Not Reduce Length of Stay in a Comprehensive Stroke Center (P1.212)
Conclusion: Palliative care consultation for patients with ischemic or hemorrhagic strokes was not associated with decreased hospital costs or LoS. This is in contrast to previously reported studies. We will further analyze the effect of early palliative care on a larger sample size to validate the findings. We also propose that a standardized palliative care trigger tool be implemented for early PC consultation in patients with debilitating stroke, advanced age, and multiple comorbid conditions.Disclosure: Dr. Tversky has nothing to disclose. Dr. Cheng has nothing to disclose. Dr. Mahmud has nothing to disclose. Dr. Schlo...
Source: Neurology - April 3, 2016 Category: Neurology Authors: Tversky, S., Cheng, D., Mahmud, S., Schloss, E., Wright, P. Tags: Re-admission and Stroke Outcomes Source Type: research

Electronic Stroke CarePath: Integrated Approach to Stroke Care Innovations in Care
We describe the development, implementation, and outcomes of the first 2 years of the Electronic Stroke CarePath, an initiative developed for management of ischemic stroke patients in an effort to improve efficiency and quality of care for patients. The CarePath consists of care pathways for ischemic stroke that are integrated within the electronic health record. Patient-reported outcomes are collected using an external software platform. Documentation tools, order sets, and clinical decision support were designed to improve efficiency, optimize process measure adherence, and produce clinical data as a byproduct of care th...
Source: Circulation: Cardiovascular Quality and Outcomes - October 29, 2015 Category: Cardiology Authors: Katzan, I. L., Fan, Y., Speck, M., Morton, J., Fromwiller, L., Urchek, J., Uchino, K., Griffith, S. D., Modic, M. Tags: Ischemic Stroke Innovations in Care Source Type: research

Medtech approvals: FDA releases August 2015 PMAs
The FDA today released its list of the pre-market approvals it granted for medical devices in August 2015: Summary of PMA Originals & Supplements Approved Originals: 2 Supplements: 70 Summary of PMA Originals Under Review Total Under Review: 57 Total Active: 28 Total On Hold: 29 Summary of PMA Supplements Under Review Total Under Review: 569 Total Active: 422 Total On Hold: 147 Summary of All PMA Submissions Originals: 5 Supplements: 90 Summary of PMA Supplement PMA Approval/Denial Decision Times Number of Approvals: 70 Number of Denials: 0 Average Days Fr Receipt to Decision (Total Time): 229.0 FDA Time: 130...
Source: Mass Device - October 23, 2015 Category: Medical Equipment Authors: Brad Perriello Tags: Food & Drug Administration (FDA) Pre-Market Approval (PMA) Regulatory/Compliance Source Type: news

How Does Cardiovascular Disease First Present in Women and Men? Incidence of 12 Cardiovascular Diseases in a Contemporary Cohort of 1,937,360 People.
CONCLUSIONS: -The majority of initial presentations of CVD are neither MI nor ischemic stroke, yet most primary prevention studies focus on these presentations. Sex has differing associations with different CVDs, with implications for risk prediction and management strategies. Clinical Trial Registration Information-www.clinicaltrials.gov. Identifier: NCT01164371. PMID: 26330414 [PubMed - as supplied by publisher]
Source: Circulation - September 1, 2015 Category: Cardiology Authors: George J, Rapsomaniki E, Pujades-Rodriguez M, Shah AD, Denaxas S, Herrett E, Smeeth L, Timmis A, Hemingway H Tags: Circulation Source Type: research

A retrospective, longitudinal study estimating the association between interdialytic weight gain and cardiovascular events and death in hemodialysis patients
Conclusions: Greater IDWG is associated with an increased risk of CV morbid events. Strategies that mitigate IDWG may improve CV health and survival among hemodialysis patients.
Source: BMC Nephrology - July 22, 2015 Category: Urology & Nephrology Authors: Claudia CabreraSteven BrunelliDavid RosenbaumEmmanuel AnumKarthik RamakrishnanDonna JensenNils-Olov StålhammarBergur Stefánsson Source Type: research

Heterogeneous associations between smoking and a wide range of initial presentations of cardiovascular disease in 1 937 360 people in England: lifetime risks and implications for risk prediction
Conclusions The heterogeneous associations of smoking with different CVD presentations suggests different underlying mechanisms and have important implications for research, clinical screening and risk prediction.
Source: International Journal of Epidemiology - February 22, 2015 Category: Epidemiology Authors: Pujades-Rodriguez, M., George, J., Shah, A. D., Rapsomaniki, E., Denaxas, S., West, R., Smeeth, L., Timmis, A., Hemingway, H. Tags: Cardiovascular Disease and Cardiovascular Risk Factors Source Type: research

Why do electronic health records reveal oral anticoagulant prescription after haemorrhagic stroke?
Source: British Journal of Clinical Pharmacology - December 1, 2014 Category: Drugs & Pharmacology Authors: Alice S Forster, Alex Dregan, Tjeerd P Staa, Lisa McDermott, Gerard McCann, Charles D A Wolfe, Anthony Rudd, Martin C Gulliford Tags: Letter 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

Outcome Assessment of Acute Ischemic Stroke Patients after Treatment with IV tPA in a Rural Health System (P02.026)
CONCLUSIONS: Patients administered IV tPA for acute ischemic stroke in a rural hospital setting experienced 90-day outcomes similar to those of historical controls. Further attempts to reduce the number of in-hospital complications and reduce time to administration may result in improved patient outcomes.Supported by: Joan Curran Memorial Summer Fellowship in Neurosciences through Gundersen Lutheran Medical Foundation.Disclosure: Dr. Milsap has nothing to disclose. Dr Aldred has received personal compensation for activities with Teva, Ipsen, and Allergan as a speaker and from Teva and Abbot as an advisor. Dr. Aldred has re...
Source: Neurology - February 14, 2013 Category: Neurology Authors: Milsap, A., Aldred, J., Skaar, J. Tags: P02 Cerebrovascular Disease II Source Type: research

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