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Importance of Considering Competing Risks in Time-to-Event Analyses: Application to Stroke Risk in a Retrospective Cohort Study of Elderly Patients With Atrial Fibrillation Original Articles
Conclusions: The incidence of death without stroke was 9-fold higher than that of stroke, leading to biased estimates of stroke risk with traditional time-to-event methods. Statistical methods that appropriately account for competing risks should be used to mitigate this bias.
Source: Circulation: Cardiovascular Quality and Outcomes - July 11, 2018 Category: Cardiology Authors: Abdel-Qadir, H., Fang, J., Lee, D. S., Tu, J. V., Amir, E., Austin, P. C., Anderson, G. M. Tags: Atrial Fibrillation, Epidemiology, Primary Prevention, Cerebrovascular Disease/Stroke Original Articles Source Type: research

Abstract 107: Differential Ischemic Stroke Risk Among Women Veterans Across Age Strata Session Title: Poster Session AM
Conclusions: Nearly half of all women Veterans were found to be at high risk of ischemic stroke within the next 10-years. Furthermore, sex differences were noted across age strata, with women having a lower risk of stroke then men at younger ages and a higher risk at older ages. Given that women tend to have more severe strokes, higher mortality, and delayed diagnosis compared to men, further work is required to understand reasons for the differential stroke risk across sexes. Based on these study findings, implementing primary prevention programs for women Veterans would help to mitigate future ischemic stroke risk.
Source: Circulation: Cardiovascular Quality and Outcomes - April 5, 2018 Category: Cardiology Authors: Comer, A. R., Sico, J., Haggstrom, D. Tags: Session Title: Poster Session AM Source Type: research

Impact of Ezetimibe on the Rate of Cardiovascular-Related Hospitalizations and Associated Costs Among Patients With a Recent Acute Coronary Syndrome: Results From the IMPROVE-IT Trial (Improved Reduction of Outcomes: Vytorin Efficacy International Trial) Original Articles
Conclusions— Addition of ezetimibe to statin therapy in patients with a recent acute coronary syndrome leads to reductions in cardiovascular-related hospitalizations and associated costs, with the greatest cost offsets in high-risk patients. These cost reductions may completely offset the cost of the drug once ezetimibe becomes generic, and may lead to cost savings from the perspective of the healthcare system, if treatment with ezetimibe is targeted to high-risk patients. Clinical Trial Registration— URL: https://www.clinicaltrials.gov. Unique Identifier: NCT00202878
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2017 Category: Cardiology Authors: Pokharel, Y., Chinnakondepalli, K., Vilain, K., Wang, K., Mark, D. B., Davies, G., Blazing, M. A., Giugliano, R. P., Braunwald, E., Cannon, C. P., Cohen, D. J., Magnuson, E. A. Tags: Secondary Prevention, Cost-Effectiveness, Health Services Original Articles Source Type: research

Abstract 037: The Accuracy of Self-reported Blood Pressure in the Medication Adherence Improvement Support App for Engagement - Blood Pressure (MedISAFE-BP) Trial Session Title: Poster Session I
Discussion: In this cohort of individuals who reported that their BP was poorly controlled, only one-third actually had elevated BP when measured with a home BP cuff. While this discrepancy may have many underlying causes, it suggests that the use of self-reported BPs is not an accurate method of monitoring hypertension control at the population-level. Reassuringly, several factors are independently associated with accurate self-reported BPs, and thus there may be some subgroups for whom self-report can be relied upon.
Source: Circulation: Cardiovascular Quality and Outcomes - March 31, 2017 Category: Cardiology Authors: Morawski, K., Ghazinouri, R., Krumme, A., Lauffenburger, J., Lee, J., Kumar, S., Oley, L., Mohta, N., Juusola, J., Choudhry, N. K. Tags: Session Title: Poster Session I Source Type: research

Preeclampsia and Future Cardiovascular Health: A Systematic Review and Meta-Analysis Original Article
Conclusions— Preeclampsia is associated with a 4-fold increase in future incident heart failure and a 2-fold increased risk in coronary heart disease, stroke, and death because of coronary heart or cardiovascular disease. Our study highlights the importance of lifelong monitoring of cardiovascular risk factors in women with a history of preeclampsia.
Source: Circulation: Cardiovascular Quality and Outcomes - February 21, 2017 Category: Cardiology Authors: Wu, P., Haththotuwa, R., Kwok, C. S., Babu, A., Kotronias, R. A., Rushton, C., Zaman, A., Fryer, A. A., Kadam, U., Chew-Graham, C. A., Mamas, M. A. Tags: Cardiovascular Disease, Pregnancy, Risk Factors, Women, Preeclampsia Original Article Source Type: research

Heat Maps of Hypertension, Diabetes Mellitus, and Smoking in the Continental United States Original Articles
Conclusions— Geographic disparities in prevalent hypertension, diabetes mellitus, and smoking exist within states and within counties in the continental United States, and the patterns differ by race.
Source: Circulation: Cardiovascular Quality and Outcomes - January 9, 2017 Category: Cardiology Authors: Loop, M. S., Howard, G., de los Campos, G., Al-Hamdan, M. Z., Safford, M. M., Levitan, E. B., McClure, L. A. Tags: Cardiovascular Disease, Epidemiology, Risk Factors Original Articles Source Type: research

Glycemic Control for Patients With Type 2 Diabetes Mellitus: Our Evolving Faith in the Face of Evidence Original Articles
Conclusions— Discordance exists between the research evidence and academic and clinical policy statements about the value of tight glycemic control to reduce micro- and macrovascular complications. This discordance may distort priorities in the research and practice agendas designed to improve the lives of patients with type 2 diabetes mellitus.
Source: Circulation: Cardiovascular Quality and Outcomes - September 19, 2016 Category: Cardiology Authors: Rodriguez-Gutierrez, R., Montori, V. M. Tags: Complications, Meta Analysis, Quality and Outcomes, Statements and Guidelines Original Articles Source Type: research

Favorable Cardiovascular Risk Profile Is Associated With Lower Healthcare Costs and Resource Utilization: The 2012 Medical Expenditure Panel Survey Original Articles
Conclusions— Favorable CRF profile is associated with significantly lower medical expenditure and healthcare utilization among individuals with and without established CVD.
Source: Circulation: Cardiovascular Quality and Outcomes - March 15, 2016 Category: Cardiology Authors: Valero-Elizondo, J., Salami, J. A., Ogunmoroti, O., Osondu, C. U., Aneni, E. C., Malik, R., Spatz, E. S., Rana, J. S., Virani, S. S., Blankstein, R., Blaha, M. J., Veledar, E., Nasir, K. Tags: Cardiovascular Disease, Lifestyle, Risk Factors Original Articles Source Type: research

Abstract 22: Impact of CHA2DS2-VASc Risk Factors on Anticoagulant Prescription in Patients with Atrial Fibrillation: Insights From the NCDR(R) PINNACLE Registry Session Title: Abstract Oral Session
Conclusions: Among this cohort of AF patients with an indication for OAC use, older age and HTN were strongly associated with greater OAC use whereas female gender and vascular disease were associated with less OAC use. Further investigation is needed to understand reasons for these differences in how risk factors influence decisions to provide OAC, such as patient or provider preference or gender bias.
Source: Circulation: Cardiovascular Quality and Outcomes - February 26, 2016 Category: Cardiology Authors: Thompson, L. E., Maddox, T. M., Lei, L., Grunwald, G. K., Bradley, S. M., Peterson, P. N., Daugherty, S. L., Masoudi, F. A. Tags: Session Title: Abstract Oral Session Source Type: research

Abstract 251: The Association Between Receipt of Healthcare Services and Post-stroke Hypertension Control Session Title: Abstract Poster Session II
We examined the receipt of health care services by patients in the one-year period following discharge for ischemic stroke.This was a retrospective cohort study of patients who were admitted for acute ischemic stroke at a Veterans Affairs hospital during year 2011 and who were discharged with a BP >140/90 mmHg. The following were reviewed: primary care visits; sub-specialty clinic visits; emergency department (ED) visits; hospitalizations; utilization of ancillary care (i.e., telehealth, pharmacy, nutrition services); medications upon discharge; adherence to medications and occurrence of recurrent stroke during the one-...
Source: Circulation: Cardiovascular Quality and Outcomes - February 26, 2016 Category: Cardiology Authors: Kohok, D., Sico, J. J., Baye, F., Myers, L., Masoor, K., Bravata, D. M. Tags: Session Title: Abstract Poster Session II Source Type: research

Quality of Care and Ischemic Stroke Risk After Hospitalization for Transient Ischemic Attack: Findings From Get With The Guidelines-Stroke Original Articles
Conclusions— TIA patients with high estimated ischemic stroke risk are less likely to receive defect-free care than low-risk patients. Standardized risk assessment and delivery of optimal inpatient care are needed to reduce this risk-treatment mismatch.
Source: Circulation: Cardiovascular Quality and Outcomes - October 29, 2015 Category: Cardiology Authors: O'Brien, E. C., Zhao, X., Fonarow, G. C., Schulte, P. J., Dai, D., Smith, E. E., Schwamm, L. H., Bhatt, D. L., Xian, Y., Saver, J. L., Reeves, M. J., Peterson, E. D., Hernandez, A. F. Tags: Ethics and Policy Original Articles Source Type: research

Who Must We Target Now to Minimize Future Cardiovascular Events and Total Mortality?: Lessons From the Surveillance, Prevention and Management of Diabetes Mellitus (SUPREME-DM) Cohort Study Original Articles
Conclusions— To sustain improvements in myocardial infarction, stroke, heart failure, and mortality, health systems that have successfully focused on care improvement in high-risk adults with DM or CVD must broaden their improvement strategies to target lower risk adults who have not yet developed DM or CVD.
Source: Circulation: Cardiovascular Quality and Outcomes - September 15, 2015 Category: Cardiology Authors: Desai, J. R., Vazquez-Benitez, G., Xu, Z., Schroeder, E. B., Karter, A. J., Steiner, J. F., Nichols, G. A., Reynolds, K., Xu, S., Newton, K., Pathak, R. D., Waitzfelder, B., Elston Lafata, J., Butler, M. G., Kirchner, H. L., Thomas, A., O'Connor, P. J., o Tags: Congestive, Type 2 diabetes, Acute myocardial infarction, Primary and Secondary Stroke Prevention Original Articles Source Type: research

Insulin Resistance and Risk of Cardiovascular Disease in Postmenopausal Women: A Cohort Study From the Women's Health Initiative Original Articles
Conclusions— Measures of insulin resistance were no longer associated with CVD risk after adjustment for high-density lipoprotein-cholesterol and did not provide independent prognostic information in postmenopausal women without diabetes mellitus. Clinical Trial Registration Information— URL: http://www.clinicaltrial.gov. Unique identifier: NCT00000611.
Source: Circulation: Cardiovascular Quality and Outcomes - May 19, 2015 Category: Cardiology Authors: Schmiegelow, M. D., Hedlin, H., Stefanick, M. L., Mackey, R. H., Allison, M., Martin, L. W., Robinson, J. G., Hlatky, M. A. Tags: Health policy and outcome research, Risk Factors, Acute myocardial infarction, Acute Cerebral Infarction, Epidemiology Original Articles Source Type: research

Model for Assessing Cardiovascular Risk in a Korean Population Original Articles
Conclusions— A risk model based on traditional clinical and biomarkers has a feasible model performance in predicting cardiovascular events in an asymptomatic Korean population.
Source: Circulation: Cardiovascular Quality and Outcomes - November 18, 2014 Category: Cardiology Authors: Park, G.-M., Han, S., Kim, S. H., Jo, M.-W., Her, S. H., Lee, J. B., Lee, M. S., Kim, H. C., Ahn, J.-M., Lee, S.-W., Kim, Y.-H., Kim, B.-J., Koh, J.-M., Kim, H.-K., Choe, J., Park, S.-W., Park, S.-J. Tags: Primary prevention Original Articles Source Type: research

Abstract 9: Predictors of Poor Outcome in Patients Not Thrombolysed Due to Mild or Resolving Symptoms ("Too Good To Treat") Session Title: Concurrent I Session B: Oral Abstracts on Stroke Topics
Conclusion: A substantial percentage of patients deemed "too good" for IV tPA were unable to be discharged home. Factors such as advanced age and higher NIHSS should be considered in tPA decision-making to optimize outcomes. Large, multi-center prospective studies are underway to study the predictors of poor outcomes in this group.
Source: Circulation: Cardiovascular Quality and Outcomes - June 2, 2014 Category: Cardiology Authors: Ali, S. F., Faheem, U., Singhal, A. B., Viswanathan, A., Silverman, S. B., Rost, N. S., Schwamm, L. H. Tags: Session Title: Concurrent I Session B: Oral Abstracts on Stroke Topics Source Type: research

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