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Safety and Use of Anticoagulation After Aortic Valve Replacement With Bioprostheses: A Meta-Analysis Original Articles
Conclusions— Contrary to the current guidelines, a meta-analysis of previous studies suggests that anticoagulation in the setting of an aortic bioprosthesis significantly increases bleeding risk without a favorable effect on thromboembolic events. Larger, randomized controlled studies should be performed to further guide this clinical practice.
Source: Circulation: Cardiovascular Quality and Outcomes - May 16, 2016 Category: Cardiology Authors: Riaz, H., Alansari, S. A. R., Khan, M. S., Riaz, T., Raza, S., Luni, F. K., Khan, A. R., Riaz, I. B., Krasuski, R. A. Tags: Anticoagulants, Aortic Valve Replacement/Transcatheter Aortic Valve Implantation Original Articles Source Type: research

Abstract 201: Are Patients With Atrial Fibrillation Willing to Consider New Strategies to Prevent Stroke? A Qualitative Analysis of Community-Based Focus Groups Session Title: Abstract Poster Session II
Conclusion: Focus group participants expressed a fear of debilitating stroke, with varying levels of acceptance of inconveniences and potential bleeding associated with blood thinners. Among a subset of participants, there was willingness to consider new stroke prevention therapies; however, this was preferred with a known, trusted physician. Subspecialized clinicians offering new therapies may be challenged to establish perceived mutual respect with patients, traditionally built over time, and this may be required for patients to consider new therapies. Future research is needed to determine best practices for both establ...
Source: Circulation: Cardiovascular Quality and Outcomes - February 26, 2016 Category: Cardiology Authors: ONeill, E. S., Grande, S. W., Coylewright, M. Tags: Session Title: Abstract Poster Session II Source Type: research

Abstract 150: Antithrombotic Use in Nonvalvular Atrial Fibrillation (NVAF): Alignment between Guidelines and Emerging Evidence with Clinician Prescribing Preferences Session Title: Poster Session I
Conclusions: Similar to findings from indirect treatment comparison studies, physicians largely prefer NOACs_particularly apixaban_compared to warfarin or aspirin for stroke risk reduction in NVAF patients. Additional research is needed to determine why NOACs are underused in practice.
Source: Circulation: Cardiovascular Quality and Outcomes - April 29, 2015 Category: Cardiology Authors: Shafrin, J., Bruno, A., MacEwan, J. P., Campinha-Bacote, A., Trocio, J., Tan, W., Romley, J. A. Tags: Session Title: Poster Session I Source Type: research

Abstract 336: Cost-effectiveness of Implantable Cardiac Monitor-guided Intermittent Anticoagulation for Paroxysmal Atrial Fibrillation Session Title: Poster Session III
Conclusions: Based on the REACT.COM pilot study, a strategy of intermittent, ICM-guided oral anticoagulation with NOACs was cost-saving relative to expected outcomes with continuous anticoagulation, with equivalent quality-adjusted survival. This strategy requires validation in a larger, randomized study.
Source: Circulation: Cardiovascular Quality and Outcomes - April 29, 2015 Category: Cardiology Authors: Steinhaus, D. A., Zimetbaum, P. J., Passman, R. S., Leong-Sit, P., Reynolds, M. R. Tags: Session Title: Poster Session III Source Type: research

Abstract 372: Health Outcomes Associated With Triple Antiplatelet Therapy for the Secondary Prevention of Atherothrombotic Events Session Title: Poster Session III
Vorapaxar is a protease-activated receptor-1 (PAR-1) antagonist indicated for the reduction of atherothrombotic cardiovascular (CV) events in patients with a history of myocardial infarction (MI) or with peripheral arterial disease (PAD), based on the findings of the TRA 2°P-TIMI 50 trial for patients without a history of stroke or transient ischemic attack. This analysis evaluated the health outcomes of triple antiplatelet therapy with vorapaxar when added to a standard care regimen of clopidogrel plus aspirin (ASA) in comparison with standard care alone, for patients without a history of transient ischemic attack or ...
Source: Circulation: Cardiovascular Quality and Outcomes - April 29, 2015 Category: Cardiology Authors: Ozer-Stillman, I., Whalen, J. D., Bash, L. D., Oguz, M., Du, M., Singhal, P. K., Davies, G. M. Tags: Session Title: Poster Session III Source Type: research

Integrating Real-Time Clinical Information to Provide Estimates of Net Clinical Benefit of Antithrombotic Therapy for Patients With Atrial Fibrillation Original Articles
Conclusions— Use of a decision support tool that integrates patient-specific stroke and bleeding risk could result in significant gains in quality-adjusted life expectancy for a primary care population of patients with atrial fibrillation.
Source: Circulation: Cardiovascular Quality and Outcomes - September 16, 2014 Category: Cardiology Authors: Eckman, M. H., Wise, R. E., Speer, B., Sullivan, M., Walker, N., Lip, G. Y. H., Kissela, B., Flaherty, M. L., Kleindorfer, D., Khan, F., Kues, J., Baker, P., Ireton, R., Hoskins, D., Harnett, B. M., Aguilar, C., Leonard, A., Prakash, R., Arduser, L., Cost Tags: Health policy and outcome research, Primary prevention, Coumarins, Thrombosis risk factors, Arrhythmias, clinical electrophysiology, drugs, Anticoagulants, Epidemiology Original Articles Source Type: research

Abstract 262: Aspirin vs. Warfarin Therapy Outcomes for Non-Valvular Atrial Fibrillation Patients with Moderate Stroke Risk Session Title: Poster Session II
Conclusion: ASA therapy was associated with a higher rate of stroke/SE but with a lower rate of bleed compared to TTR ≥55% warfarin in NVAF patients with CHADS2=1. These results suggest that treatment decisions should be carefully made based on the risk and benefit assessment in patients whose CHADS2=1.
Source: Circulation: Cardiovascular Quality and Outcomes - June 2, 2014 Category: Cardiology Authors: An, J., Jazdzewski, K. P., Le, P. T., Rashid, N., Lang, D. T., Niu, F., Meissner, B., Mendes, R., Dills, D., Bruno, A. Tags: Session Title: Poster Session II Source Type: research

Abstract 15: Frequency and Predictors of Inappropriate Aspirin Prescribing for Primary Prevention of Cardiovascular Disease: Insights from the NCDR(R) PINNACLE Registry. Session Title: Concurrent I Session C: Young Investigator Award Finalists Oral Abstract Presentations
Conclusion: Inappropriate aspirin prescribing occurs in approximately one third of patients receiving aspirin for primary prevention. There is modest but significant practice-level variation. Our findings identify opportunities to improve evidence-based aspirin prescribing in primary CVD prevention.
Source: Circulation: Cardiovascular Quality and Outcomes - June 2, 2014 Category: Cardiology Authors: Hira, R. S., Kennedy, K. F., Nambi, V., Jneid, H., Alam, M., Basra, S. S., Ho, M., Deswal, A., Ballantyne, C. M., Petersen, L. A., Virani, S. S. Tags: Session Title: Concurrent I Session C: Young Investigator Award Finalists Oral Abstract Presentations Source Type: research

Abstract 231: Under Utilization of Aspirin for Primary Prevention Poster Session II
Conclusion: Aspirin is being under-utilized as part of primary prevention strategy. The presence of diabetes and an elderly patient often prompts a recommendation for aspirin use. A conscious effort should be made by hospital based care providers to ensure that the appropriate preventive strategies are part of their discharge medication list.
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Gopalakrishnan, M., Silva-Palacios, F., Villines, D., Klein, L. Tags: Poster Session II Source Type: research