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Non-vitamin K antagonist oral anticoagulants and atrial fibrillation guidelines in practice: barriers to and strategies for optimal implementation
Stroke is a leading cause of morbidity and mortality worldwide. Atrial fibrillation (AF) is an independent risk factor for stroke, increasing the risk five-fold. Strokes in patients with AF are more likely than other embolic strokes to be fatal or cause severe disability and are associated with higher healthcare costs, but they are also preventable. Current guidelines recommend that all patients with AF who are at risk of stroke should receive anticoagulation. However, despite this guidance, registry data indicate that anticoagulation is still widely underused. With a focus on the 2012 update of the European Society of Car...
Source: Europace - June 26, 2015 Category: Cardiology Authors: Camm, A. J., Pinto, F. J., Hankey, G. J., Andreotti, F., Hobbs, F. D. R., on behalf of the Writing Committee of the Action for Stroke Prevention alliance, on behalf of the Writing Committee of the Action for Stroke Prevention alliance, John Camm, Pinto, H Tags: REVIEW Source Type: research

Medicare beneficiary out-of-pocket spending for stroke prevention in non-valvular Atrial Fibrillation: a budget analysis
Healthcare costs today are increasingly being shifted from payers to patients, yet few providers factor patient costs into treatment decisions. Recent advancements in stroke prevention in atrial fibrillation (AF) have resulted in new treatment options where previously there were few. While the clinical benefit and cost effectiveness of these treatments are supported by a growing body of evidence, the cost impact to patients has not been explored. This analysis sought to quantify patient out-of-pocket costs for three stroke prevention strategies: warfarin, dabigatran and left atrial appendage closure (LAAC) with the Watchman Device.
Source: Value in Health - May 1, 2015 Category: Global & Universal Authors: S. Armstrong, S.L. Amorosi, G. Erickson, P. Patel, K. Stein Source Type: research

Abstract 221: Outcomes Associated with Warfarin Time in Therapeutic Range Among Nonvalvular Atrial Fibrillation Patients Treated in an Integrated Healthcare Delivery System in the U.S. Session Title: Poster Session II
Conclusions: NVAF patients with low warfarin TTR, in comparison to those with high warfarin TTR, used more healthcare resources resulting in higher healthcare costs.
Source: Circulation: Cardiovascular Quality and Outcomes - April 29, 2015 Category: Cardiology Authors: Deitelzweig, S., Evans, M., Hillson, E., Trocio, J., Bruno, A., Tan, W., Lingohr-Smith, M., Lin, J. Tags: Session Title: Poster Session II 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 301: Healthcare Costs Following Stroke and Major Bleeding Events in Nonvalvular Atrial Fibrillation Patients Session Title: Poster Session III
Conclusions: NVAF patients who have a stroke or MB event incur higher healthcare costs relative to patients without events. Interventions preventing stroke or MB events have the potential to reduce the healthcare burden associated NVAF.
Source: Circulation: Cardiovascular Quality and Outcomes - April 29, 2015 Category: Cardiology Authors: Naccarelli, G., Stokes, M., DeLeon, A., Tate, N., Wang, R., Wang, A., Fredell, J. Tags: Session Title: Poster Session III Source Type: research

An electronic decision support tool for Stroke Prevention in Atrial Fibrillation (SPAF): An integrated primary-tertiary care model of care. (S47.001)
CONCLUSIONS: Given that the existing technology base is well established nationwide, it is expected that this could become a national model which would have significant benefits for patient care and healthcare costs across the country.Disclosure: Dr. Jolliffe has nothing to disclose. Dr. Rosemergy has nothing to disclose. Dr. Lanford has nothing to disclose. Dr. Abernethy has nothing to disclose. Dr. Ranta has nothing to disclose.
Source: Neurology - April 8, 2015 Category: Neurology Authors: Jolliffe, E., Rosemergy, I., Lanford, J., Abernethy, D., Ranta, A. Tags: Cerebrovascular Disease and Interventional Neurology Source Type: research

Antithrombotic treatment for stroke prevention in atrial fibrillation: The Asian agenda
Atrial fibrillation (AF) is the most common heart arrhythmia. Untreated AF incurs a considerable burden of stroke and associated healthcare costs. Asians have AF risk factors similar to Caucasians and similarly increased risk of AF-related stroke; however, with a vast and rapidly aging population, Asia bears a disproportionately large disease burden. Urgent action is warranted to avert this potential health crisis. Antithrombotic therapy with oral anticoagulants is the most effective means of preventing stroke in AF and is a particular priority in Asia given the increasing disease burden.
Source: International Journal of Cardiology - March 26, 2015 Category: Cardiology Authors: Chen-Huan Chen, Mien-Cheng Chen, Harry Gibbs, Sun U. Kwon, Sidney Lo, Young Keun On, Azhari Rosman, Nijasri C. Suwanwela, Ru San Tan, Louie S. Tirador, Andreas Zirlik Tags: Review Source Type: research

Practical aspects of treatment with target specific anticoagulants: initiation, payment and current market, transitions, and venous thromboembolism treatment
Abstract Target specific anticoagulants (TSOACs) have recently been introduced to the US market for multiple indications including venous thromboembolism (VTE) prevention in total hip and knee replacement surgeries, VTE treatment and reduction in the risk of stroke in patients with non-valvular atrial fibrillation (NVAF). Currently, three TSOACs are available including rivaroxaban, apixaban, and dabigatran with edoxaban currently under Food and Drug Administration review for VTE treatment and stroke prevention in NVAF. The introduction of these agents has created a paradigm shift in anticoagulation by considerably...
Source: Journal of Thrombosis and Thrombolysis - January 21, 2015 Category: Hematology Source Type: research

Abstract 242: Healthcare Resource Utilization and Costs among Patients with Non-Valvular Atrial Fibrillation using Dabigatran or Warfarin For Stroke Prevention Session Title: Poster Session II
Conclusions: Although newly diagnosed, newly treated NVAF patients initiated on dabigatran had higher pharmacy costs than those on warfarin, the total healthcare costs were similar between the two cohorts. In addition, fewer office visits were observed in the dabigatran cohort.
Source: Circulation: Cardiovascular Quality and Outcomes - June 2, 2014 Category: Cardiology Authors: Fu, A.-C., Jain, R., Sander, S. D., Lim, J., Jain, G., Yu, Y., Tan, H. Tags: Session Title: Poster Session II Source Type: research

Risk factors for atrial fibrillation recurrence: a literature review
Atrial fibrillation is the most common arrhythmia managed in clinical practice and it is associated with an increased risk of mortality, stroke and peripheral embolism. Unfortunately, the incidence of atrial fibrillation recurrence ranges from 40 to 50%, despite the attempts of electrical cardioversion and the administration of antiarrhythmic drugs. In this review, the literature data about predictors of atrial fibrillation recurrence are highlighted, with special regard to clinical, therapeutic, biochemical, ECG and echocardiographic parameters after electrical cardioversion and ablation. Identifying predictors of success...
Source: Journal of Cardiovascular Medicine - March 1, 2014 Category: Cardiology Tags: Reviews: Atrial fibrillation Source Type: research

Impact of Atrial Fibrillation on Stroke-Related Healthcare Costs Stroke
Conclusion Stroke-related care for IS, HS, and TIA is costly, especially among individuals with AF. Reducing the risk of AF-related stroke is important from both clinical and economic standpoints.
Source: JAHA:Journal of the American Heart Association - November 25, 2013 Category: Cardiology Authors: Sussman, M., Menzin, J., Lin, I., Kwong, W. J., Munsell, M., Friedman, M., Selim, M. Tags: Stroke Source Type: research

Impact of Atrial Fibrillation on Stroke-Related Healthcare Costs Hypertension
Conclusion Stroke-related care for IS, HS, and TIA is costly, especially among individuals with AF. Reducing the risk of AF-related stroke is important from both clinical and economic standpoints.
Source: JAHA:Journal of the American Heart Association - November 25, 2013 Category: Cardiology Authors: Sussman, M., Menzin, J., Lin, I., Kwong, W. J., Munsell, M., Friedman, M., Selim, M. Tags: Hypertension Source Type: research

Stroke prevention for patients with atrial fibrillation: improving but not perfect yet
Atrial fibrillation (AF) is the most common cardiac rhythm disorder1 and one of the most important risk factors for stroke, particularly in the elderly. Stroke-related AF is associated with significant morbidity, mortality and healthcare costs.2 Although we have abundant evidence from randomised trials that anticoagulation, and to a lesser extent antiplatelet therapy, is highly efficacious in preventing stroke in patients with AF, these therapies remain underused, especially in older patients. With an ageing population and an AF prevalence that is rapidly rising,1 a better understanding of the stroke prevention practices i...
Source: Heart - July 19, 2013 Category: Cardiology Authors: Sandhu, R. K., McAlister, F. A. Tags: Health policy, Drugs: cardiovascular system, Epidemiology Editorials Source Type: research

Interventions for preventing post-operative atrial fibrillation in patients undergoing heart surgery.
CONCLUSIONS: Prophylaxis to prevent atrial fibrillation after cardiac surgery with any of the studied pharmacological or non-pharmacological interventions may be favored because of its reduction in the rate of atrial fibrillation, decrease in the length of stay and cost of hospital treatment and a possible decrease in the rate of stroke. However, this review is limited by the quality of the available data and heterogeneity between the included studies. Selection of appropriate interventions may depend on the individual patient situation and should take into consideration adverse effects and the cost associated with each ap...
Source: Cochrane Database of Systematic Reviews - March 2, 2013 Category: Journals (General) Authors: Arsenault KA, Yusuf AM, Crystal E, Healey JS, Morillo CA, Nair GM, Whitlock RP Tags: Cochrane Database Syst Rev Source Type: research

Outcomes in atrial fibrillation patients on combined warfarin & antiarrhythmic therapy
Conclusions: Allowing for differences in prescribing practice, AF/AFL patients treated with W+A are at higher risk of stroke and arterial embolism, and have higher healthcare use and costs, than patients receiving W+OAAD.
Source: International Journal of Cardiology - February 15, 2012 Category: Cardiology Authors: Annie Guérin, Jay Lin, Mehul Jhaveri, Eric Q. Wu, Andrew P. Yu, Martin Cloutier, Genevieve Gauthier, Joseph S. Alpert Tags: Original Articles Source Type: research

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