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Comparative effectiveness and safety between non-VKA oral anticoagulants in non-valvular atrial fibrillation patients: A dose subgroup analysis of the ARISTOPHANES Study
ConclusionsAmong NVAF pts, both standard- and lower-dose api pts had lower rates of MB compared to corresponding doses of dabi and riva, respectively; both doses of api demonstrated lower rates of S/SE vs. corresponding doses of riva. The comparisons between dabi and riva showed varying results for S/SE and MB across dosage levels. Dose selection criteria cannot be ascertained from the current data sources. Future studies of pts who were appropriately dosed are warranted.
Source: Archives of Cardiovascular Diseases Supplements - December 25, 2018 Category: Cardiology Source Type: research

Comparative effectiveness and safety of non-vitamin K antagonist oral anticoagulants versus warfarin in non-valvular atrial fibrillation patients: The dose subgroup analysis of the ARISTOPHANES study
ConclusionsIn this large observational study, api was the only NOAC associated with lower rates of S/SE and MB for both doses compared to warf. Dose selection criteria cannot be ascertained from current data sources. Future studies of pts who were appropriately dosed should be warranted.
Source: Archives of Cardiovascular Diseases Supplements - December 25, 2018 Category: Cardiology Source Type: research

Impact of Complications on Resource Utilization during 90-day CABG Bundle for Medicare Beneficiaries
ConclusionsMedicare beneficiaries that experience adverse events during their index CABG hospitalization will significantly impact that hospital’s financial risk. The challenge under the voluntary CABG bundled payment program will be to monitor and reduce adverse events and managing the services consumed by Medicare beneficiaries experiencing adverse events delivered at all the venues of care.
Source: The Annals of Thoracic Surgery - December 14, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Impact of Complications on Resource Utilization during 90-day CABG Bundle for Medicare Beneficiaries.
CONCLUSIONS: Medicare beneficiaries that experience adverse events during their index CABG hospitalization will significantly impact that hospital's financial risk. The challenge under the voluntary CABG bundled payment program will be to monitor and reduce adverse events and managing the services consumed by Medicare beneficiaries experiencing adverse events delivered at all the venues of care. PMID: 30553739 [PubMed - as supplied by publisher]
Source: The Annals of Thoracic Surgery - December 13, 2018 Category: Cardiovascular & Thoracic Surgery Authors: Culler SD, Brown PP, Kugelmass AD, Cohen DJ, Reynolds MR, Katz MR, Schlosser ML, Simon AW Tags: Ann Thorac Surg Source Type: research

Persistently low inferior vena cava filter retrieval rates in a population-based cohort
ConclusionsIVC filter placements, after a substantial increase between 2004 and 2010, have been declining since 2010. Retrieval rates in the general population are steadily improving but continue to lag behind those described in center-specific literature. Increased age and Medicare as the primary payer are the strongest risk factors for lack of filter retrieval. Widespread improvements on a national scale are needed to improve the appropriateness of filter placements and to enhance filter retrieval rates.
Source: Journal of Vascular Surgery: Venous and Lymphatic Disorders - November 14, 2018 Category: Surgery Source Type: research

Discharge Patterns for Ischemic and Hemorrhagic Stroke Patients Going From Acute Care Hospitals to Inpatient and Skilled Nursing Rehabilitation
Conclusions This study suggests demographic and clinical differences among stroke patients admitted for postacute rehabilitation at inpatient rehabilitation facilities and skilled nursing facilities settings. Furthermore, examination of variation in ischemic and hemorrhagic stroke discharges suggests acute facility-level differences and indicates a need for careful consideration of patient and facility factors when comparing the effectiveness of inpatient rehabilitation facilities and skilled nursing facilities rehabilitation.
Source: American Journal of Physical Medicine and Rehabilitation - August 17, 2018 Category: Rehabilitation Tags: Original Research Articles Source Type: research

Safety of Antidepressant Classes Used Following Traumatic Brain Injury Among Medicare Beneficiaries: A Retrospective Cohort Study
ConclusionCompared with SSRIs, use of SNRIs and TCAs following hospitalization for TBI among Medicare beneficiaries was not associated with an increased risk of any of the studied adverse events. Compared to TCAs, SSRI use was associated with increased risk of hemorrhagic stroke. This information may help guide patients and prescribers in selecting antidepressants for older adults following TBI.
Source: Drugs and Aging - July 26, 2018 Category: Geriatrics Source Type: research

Unrecognized Cardiovascular Emergencies Among Medicare Patients
This cohort study estimates the proportions of emergency department visits attributable to symptoms of imminent ruptured abdominal aortic aneurysm, acute myocardial infarction, stroke, aortic dissection, and subarachnoid hemorrhage that end in discharge without diagnosis.
Source: JAMA Internal Medicine - February 26, 2018 Category: Internal Medicine Source Type: research

TCT 2017: Boston Scientific touts lowered hemorrhagic stroke rate, cost for patients in Watchman studies
Boston Scientific (NYSE:BSX) today released combined 5-year outcomes data from both the Prevail and Protect-AF study of its Watchman left atrial appendage closure device, touting it as a safe and effective an alternative to long-term warfarin therapy for patients with non-valvular atrial fibrillation. Five-year data from the Prevail study was published online today in the Journal of the American College of Cardiology. In both trials, the Marlborough, Mass.-based company compared the Watchman device to warfarin treatment for stroke prevention in patients with non-valvular AF with follow-ups out to five years. A combined an...
Source: Mass Device - November 2, 2017 Category: Medical Devices Authors: Fink Densford Tags: Cardiac Implants Cardiovascular Clinical Trials Boston Scientific Source Type: news

Cost-effectiveness analysis of dabigatran versus rivaroxaban for stroke prevention in patients with non-valvular atrial fibrillation using real-world evidence in elderly US Medicare beneficiaries.
CONCLUSIONS: In this study using US Medicare real-world data, dabigatran was found to dominate rivaroxaban. The analyses were limited by the short follow-up period of the real-world data and results may not be generalizable to other patient populations. PMID: 28862479 [PubMed - as supplied by publisher]
Source: Current Medical Research and Opinion - September 3, 2017 Category: Research Tags: Curr Med Res Opin Source Type: research

Hospital Discharge Disposition of Stroke Patients in Tennessee.
CONCLUSIONS: Our investigation revealed that the hospital discharge disposition pattern of patients with stroke in Tennessee was associated with the key patient characteristics of selected demographics, clinical indicators, and insurance status. These analyses resulted in the development of an easy-to-use predictive tool for early determination of hospital discharge disposition status. PMID: 28863224 [PubMed - in process]
Source: Southern Medical Journal - September 3, 2017 Category: General Medicine Tags: South Med J Source Type: research

Dabigatran Compared With Rivaroxaban vs Warfarin
To the Editor In a recent issue ofJAMA Internal Medicine, Graham et al reported that rivaroxaban use increased risks of major bleeding with nonsignificant reduction in thromboembolic stroke and increased mortality compared with dabigatran in elderly Medicare beneficiaries newly treated with dabigatran or rivaroxaban for nonvalvular atrial fibrillation (November 2011-June 2014). However, dabigatran event rates were lower than reported by Graham et al in a larger group of elderly Medicare beneficiaries newly treated with dabigatran or warfarin for nonvalvular atrial fibrillation with longer follow-up during a partially overl...
Source: JAMA Internal Medicine - May 1, 2017 Category: Internal Medicine Source Type: research

Predictive indices for functional improvement and deterioration, institutionalization, and death among elderly Medicare beneficiaries
Conclusion Predictive indices, or point and scoring systems used to predict outcomes, can identify elderly Medicare beneficiaries at risk of functional deterioration, institutionalization, and death and can aid policy makers, clinicians, and family members in improving care for older adults and supporting successful aging in the community.
Source: PMandR - April 27, 2017 Category: Rehabilitation Source Type: research

Abstract 072: Impact of Chronic Diabetes on Periprocedural Outcomes Among Patient With Atrial Fibrillation and Flutter Who Underwent Radiofrequency Catheter Ablation Therapy (RFA). Report From the NIS 2014. Session Title: Poster Session I
Conclusions: RFA has a similar procedural safety in diabetics when compared to non-diabetic patients. It remains a safe procedure in diabetics with drug-refractory atrial fibrillation and flutter. Renal failure, CHF, type of Insurance, hospital location and teaching status are predictors of complications after RFA.
Source: Circulation: Cardiovascular Quality and Outcomes - March 31, 2017 Category: Cardiology Authors: Alliu, S. E., Adejumo, A., Durojaiye, M., Emmanuel, A., Wolf, L., Lichstein, E., Hecht, M., Stephan, K., Adegbala, O., Onyeakusi, N., Ajayi, T. Tags: Session Title: Poster Session I Source Type: research

Risk of Stroke Among Older Medicare Antidepressant Users With Traumatic Brain Injury
Conclusion: Findings from this study will aid prescribers in choosing appropriate antidepressants to treat depression in older adults with TBI.
Source: The Journal of Head Trauma Rehabilitation - January 1, 2017 Category: Neurology Tags: Focus on Clinical Research and Practice Source Type: research

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