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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

Abstract 109: Neurologists versus Hospitalists: The Effect of Physician Specialty on Stroke Care and Outcomes After Ischemic Stroke and TIA Session Title: Poster Session AM
Conclusions: There is no evidence that patients received dissimilar stroke related care or experienced different outcomes regardless of the physician specialty serving as the primary service. However, stroke patients with hospitalists as their primary team had shorter hospital stay. This difference may be due to hospitalists’ expertise in managing patients with multiple co-morbidities, including stroke patients with underlying diabetes, atrial fibrillation, and hypertension. Based on these findings, utilizing neurology as a consult service for stroke related care will not affect provision of stroke care or patient outcomes.
Source: Circulation: Cardiovascular Quality and Outcomes - April 5, 2018 Category: Cardiology Authors: Comer, A. R., Comer, A. D., Dethoff, A., Templeton, E. J., Slaven, J. J. Tags: Session Title: Poster Session AM Source Type: research

Abstract 110: Prevalence of Neurological Illness, Stroke and Associated Mortality on a Ugandan Neurology Ward Session Title: Poster Session AM
Conclusions: Among patients admitted to a Ugandan neurology ward, stroke was the most common diagnosis and the most frequently associated with mortality. Given that such non-communicable diseases as cerebrovascular disease is becoming increasingly more important causes of death in resource-limited settings, future research should seek to understand how mortality relates to other factors during hospitalizations and whether interventions to improve delivery of care to patients at higher risk of mortality may affect patient outcomes.
Source: Circulation: Cardiovascular Quality and Outcomes - April 5, 2018 Category: Cardiology Authors: Diaz, M., Hu, X., Fenton, B., Sico, J. Tags: Session Title: Poster Session AM Source Type: research

Abstract 131: Recurrent Acute Cardiovascular Events and Statin Use Session Title: Poster Session AM
Conclusion: While statin use substantially increased after an index CV event, nearly 40% of patients remained untreated, increasing their recurrent CV event risk by 76%. Initiation and continuation of statin therapy after CV events remains a large public health opportunity for patients with ASCVD.
Source: Circulation: Cardiovascular Quality and Outcomes - April 5, 2018 Category: Cardiology Authors: Tecson, K. M., Kluger, A. Y., DiMario, S., Harrison, D. J., McCullough, P. A. 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 226: Strokes Worse in Women at 24 hours but Severity Reduced in Younger Women With Hormone Therapy Session Title: Poster Session II
Conclusion: Women in this study had more severe 24 hour AIS outcomes than men but this improved with HRT use in women younger than 80 years. This cannot be fully explained by age differences as there could be other underlying factors. Improving 24 hour NIHSS may correctly predict later outcomes following AIS. Further study of HRT use in AIS outcomes is justified.
Source: Circulation: Cardiovascular Quality and Outcomes - March 31, 2017 Category: Cardiology Authors: Brown, A., Onteddu, S., Joiner, R., Benton, T., Culp, W., Lowery, C. Tags: Session Title: Poster Session II Source Type: research

Abstract 013: Using the Diabetes Collaborative Registry (DCR) to Estimate the Potential Real-world Impact of the Iris Trial on Improving Outcomes in Patients With Cerebrovascular Disease Session Title: Poster Session I
Conclusion: In a large US-based outpatient registry, we found that 12% of outpatients with prediabetes or diet-controlled T2D met the main eligibility criteria for IRIS, partly due to the narrow inclusion criteria of the trial but also likely reflective of a general paucity of screening for prediabetes and insulin resistance in this cohort. Pioglitazone was rarely used in these patients but could have a substantial impact on CV outcomes in these eligible patients. The population impact could be even greater if the CV benefit of pioglitazone can be demonstrated in patients with cerebrovascular disease and overt T2D or even ...
Source: Circulation: Cardiovascular Quality and Outcomes - March 31, 2017 Category: Cardiology Authors: Arnold, S. V., Inzucchi, S. E., Tang, F., McGuire, D. K., Mehta, S. N., Maddox, T. M., Goyal, A., Sperling, L. S., Einhorn, D., Wong, N. D., Kosiborod, M. Tags: Session Title: Poster Session I 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

Abstract 043: Health Insurance and the Risk of Incident Cardiovascular Disease in the Multi-Ethnic Study of Atherosclerosis Session Title: Poster Session I
Conclusions: The association of health insurance with CVD incidence varied by insurance group, and private insurance was associated with a lower risk of incident CVD. Further exploration of the features of health insurance coverage that impact CVD incidence may facilitate improvements in the primary prevention of CVD.
Source: Circulation: Cardiovascular Quality and Outcomes - March 31, 2017 Category: Cardiology Authors: Crim, M. T., Xie, J. X., Ko, Y.-A., Blumenthal, R. S., Blaha, M. J., Nasir, K., Budoff, M. J., Shaw, L. J. Tags: Session Title: Poster Session I 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

Abstract 122: Quality of Care for Patients With Acute Ischemic Stroke as a Function of Hospital Intravenous Thrombolysis With Recombinant Tissue Plasminogen Activator Capability: Insights From China National Stroke Registry II Session Title: Poster Session I
Conclusions: The CNSR II hospitals were associated with better performance in some of the hospitals but not all of them. The difference in conformity between rt-PA-capable hospitals and rt-PA-incapable hospitals was modest for performance measures of stroke care. However, more room for improvement still exists in key quality performance measures and further studies should be explored.
Source: Circulation: Cardiovascular Quality and Outcomes - March 31, 2017 Category: Cardiology Authors: Rao, Z., Li, Z., Gu, H., Wang, Y., Wang, Y. Tags: Session Title: Poster Session I Source Type: research

Abstract 123: Temporal Variation Affect Stroke Unit Admission Rates, Observations From the National Swedish Stroke Register Session Title: Poster Session I
Discussion: There are several patterns of time affecting admission rates to a SU from the ED. Some of the variation seen in this study could possibly be explained by healthcare organizational factors such as hospital crowding. More studies are however needed to elucidate the mechanisms behind temporal variations as well as the magnitude of these effects on the quality of stroke care. Finally, we believe quality improvement efforts should focus on reducing temporal variation.
Source: Circulation: Cardiovascular Quality and Outcomes - March 31, 2017 Category: Cardiology Authors: Darehed, D., Blom, M., Glader, E.-L., Niklasson, J., Norrving, B., Eriksson, M. Tags: Session Title: Poster Session I Source Type: research

Abstract 127: Differences in Care Patterns, Health Status, and Outcomes of Atrial Fibrillation in Patients With and Without Diabetes: Findings From the ORBIT-AF Registry Session Title: Poster Session I
Conclusions: Among patients with AF, diabetes was associated with worse AF symptoms and lower quality of life, as well an increased risk of death and hospitalizations, but not with the risk of thromboembolic or bleeding events.
Source: Circulation: Cardiovascular Quality and Outcomes - March 31, 2017 Category: Cardiology Authors: Echouffo Tcheugui, J. B., Shrader, P., Thomas, L., Gersh, B. J., Kowey, P., Mahaffey, K. W., Singer, D. E., Hylek, E. M., Go, A. S., Peterson, E. D., Piccini, J. P., Fonarow, G. C. F. C. Tags: Session Title: Poster Session I Source Type: research

Abstract 137: Clinical Outcomes After Cardiac Stress Testing Among U.S. Patients Younger Than 65, 2006-2012 Session Title: Poster Session I
Conclusion: The percentage of commercially insured U.S. patients who had an AMI or revascularization event within 1 year of stress testing was small. In the lowest risk quintile, the a priori prevalence of coronary disease risk factors was low, and the rates of subsequent AMI and revascularization was extremely low, raising questions about the value of stress testing in this subgroup.
Source: Circulation: Cardiovascular Quality and Outcomes - March 31, 2017 Category: Cardiology Authors: Kini, V., Dayoub, E., Marzec, L., Dickinson, M., Wynia, M., Masoudi, F., Ho, M., Groeneveld, P. Tags: Session Title: Poster Session I Source Type: research

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