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Abstract 24: Current Quality of Cardiovascular Prevention for Million Hearts™: An Analysis of 115,737 Outpatients from The Guideline Advantage™ Concurrent III Session A: Oral Abstract Presentations on EHS & Health IT
Conclusions: Compliance with clinical quality measures for the Million Hearts™ initiative varies widely across outpatient practices. Our findings identify multiple opportunities to improve the quality of outpatient care for cardiovascular prevention.
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Eapen, Z., Bufalino, V., Peterson, E., Hernandez, A. Tags: Concurrent III Session A: Oral Abstract Presentations on EHS & amp; Health IT Source Type: research

Abstract 33: Incidence Of Urinary Tract Infection Among Patients With Acute Cerebrovascular Accidents: A Possible Trigger For Stroke Poster Session I
Conclusion:Our findings provide some evidence that the incidence of UTI is significantly higher for patients with CVA than is found in the general population
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: kali, M., Kuruvilla, J., Lucas, D., Broce, M., Seybold, D., Reyes, B. Tags: Poster Session I Source Type: research

Abstract 200: Cost-Effectiveness of Newer Anticoagulants for Stroke Prevention in Atrial Fibrillation Poster Session II
Conclusions: Cost-effectiveness models of newer anticoagulants for SPAF have been extensively published. Models have frequently found newer anticoagulants to be cost-effective, but due to the lack of head-to-head trial comparisons and heterogeneity in clinical characteristic of underlying trials and modeling methods, it is currently unclear which of these newer agents is most cost-effective.
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Limone, B. L., Baker, W. L., Coleman, C. I. Tags: Poster Session II Source Type: research

Abstract 203: Outcomes Comparison of Low Risk Medical and Surgical Patients Treated with Unfractionated Heparin vs. Enoxaparin Poster Session II
Conclusions: In low-risk medical and general surgical patients, UFH was as effective as enoxaparin in the prevention of thromboembolic events, with no difference in the incidence of HIT. When compared to UFH, enoxaparin was associated with lower MI and mortality rates, and shorter LOS and ICU LOS, at the expense of higher rates of stroke and TIA. Enoxaparin was associated with lower total inpatient costs than UFH.
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Corbelli, J., Zammit, K., Griffiths, B., Ma, C., Tung, Y., Graves, C., Genena, D., Boyd, D., Meyer, F., Arbogast, P., Bourji, M. Tags: Poster Session II Source Type: research

Abstract 205: New Onset Heart Failure and Adverse Ischemic Events Associated with Amiodarone and Dronedarone Use among Atrial Fibrillation Patients Poster Session II
Conclusions: In a propensity score matched observational cohort study, amiodarone use was associated with higher incidence rate of new onset HF, HF hospitalizations, and TIA as identified from claims. This finding differs from other clinical studies. Future observational cohort studies should incorporate medical record review for validation since information from claims might be insufficient to fully account for underlying patient risk status, or accurately determine if HF was new onset.Key words: amiodarone; dronedarone; atrial fibrillation; heart failure.
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Sylwestrzak, G., Liu, J., Rosenberg, A., White, J., Barron, J., Redberg, R., Malenka, D. Tags: Poster Session II Source Type: research

Abstract 206: Expansion Of Emergency Medical Services Routing For Stroke In The United States Poster Session II
Conclusions: In 2010 a majority of stroke patients in the United States were hospitalized in an area with established or transitioning to EMS diversion. This milestone coverage of half the US population is a major advance in systematic stroke care, and emphasizes the need for novel approaches, such as telemedicine, to further extend access to stroke center care to all patients.
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Sanossian, N., Hanks, N., He, S., Wen, G., Krug, A. M., Kim-Tenser, M., Cen, S., Song, S., Saver, J. L., Adamczyk, P., Mack, W. J. Tags: Poster Session II Source Type: research

Abstract 209: Analysis of the Costs and Payments of a Coordinated Stroke Center and Regional Stroke Network Poster Session II
Conclusions: This analysis indicates that SLNI has successfully implemented a comprehensive program with coordinated regional care, dedicated high-level staffing, state-of-the-art technology, and process efficiencies that results in better access and care while overall total hospital costs remained unchanged. However, SLNI total operating costs continue to outweigh payments, similar to that observed in previous studies, indicating the need for further reimbursement consideration. Despite such reimbursement challenges, this study suggests a comprehensive stroke care program with improved access and treatment may be financia...
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Rymer, M. M., Armstrong, E. P., Meredith, N. R., Pham, S. V., Thorpe, K., Kruzikas, D. T. Tags: Poster Session II Source Type: research

Abstract 211: Association of Patient Characteristics With the Initiation of Dabigatran Versus Warfarin Among Anticoagulant Naive Patients With Non-valvular Atrial Fibrillation Poster Session II
Conclusions: Patients who are younger, male, Caucasian, and recently diagnosed with NVAF were significantly more likely to be initiated by their physician on DE vs. warfarin. These findings should be considered when doing comparative analyses of outcomes between patients on DE vs. warfarin.
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Walker, D. R., Ivanova, J., Betts, K. A., Rao, S., Wu, E. Q. Tags: Poster Session II Source Type: research

Abstract 213: The Smoking Paradox in Acute Ischemic Stroke: Findings from Get With The Guidelines - Stroke Poster Session II
Conclusion: Smoking continues to be a major risk factor for presenting with acute ischemic stroke at a much younger age and with fewer vascular risk factors. The association with lower in-hospital mortality, even after covariate adjustment, may represent residual confounding due to the marked age differences and unmeasured confounding or it may reflect a protective association. Further research is warranted.
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Ali, S. F., Smith, E. E., Bhatt, D. L., Pan, W., Fonarow, G. C., Schwamm, L. H. Tags: Poster Session II Source Type: research

Abstract 214: Improvement Among All Hospital Types and Reduced Hospital Level Variation in Use of Intravenous tPA for Acute Ischemic Stroke 2003-2011: Findings from Get With The Guideline-Stroke Poster Session II
Conclusion: Significant increases in IV tPA treatment among patients arriving < 2hr have occurred over the past decade, and rates of increase vary by hospital characteristics. The profile of tPA treated eligible patients also changes across the range of hospital tPA use rates, with highest performing sites reporting NIHSS in >90% of tPA patients, and treating greater numbers of patients who are non-white or with more severe strokes. Low performing sites may benefit from greater focus on NIHSS assessment and timeliness of care. .
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Schwamm, L. H., Ali, S. F., Reeves, M. J., Smith, E. E., Saver, J. L., Messe, S., Bhatt, D. L., Grau-Sepulveda, M. V., Peterson, E. D., Fonarow, G. C. Tags: Poster Session II Source Type: research

Abstract 215: Differing Perspectives Between Physicians, Patients And Caregivers On The Value Of An Individualized Estimate Of The Benefits Of Thrombolysis At The Time Of Acute Ischemic Stroke: Designing The Resolve (Rapid Evaluation for Stroke Outcomes using Lytics in Vascular Event) Decision Aid Poster Session II
Conclusions: Preliminary findings suggest reluctance by emergency physicians to share data about the benefits of rt-PA to stroke patients and their caregivers, despite the desire of the latter for such information. While the additional planned interviews will be needed to confirm these findings, preliminary insights suggest a compelling need to overcome the reticence of emergency physicians to use clinical data to better engage patients in making a shared decision about rt-PA in AIS.
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Decker, C. J., Chhatriwalla, E., Garavalia, B., Spertus, J. A., Chen, E., Gialde, E. Tags: Poster Session II Source Type: research

Abstract 219: What factors influence the decision to refer patients to a stroke center in an Emergency Medical Service Dispatch Center? Poster Session II
Conclusion: in our study 26% of callers were referred to a SC, age and delay influenced this decision. Enforced implementation of recent recommendations and standard training in stroke recognition will improve EMS pathways to SC.
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: FREDERIC, M., Ozguler, A., Loeb, T., Baer, M. Tags: Poster Session II Source Type: research

Abstract 221: National and Regional Trends in Hospitalizations for Ischemic Stroke after Acute Myocardial Infarction in the United States: 1999-2010 Poster Session II
Conclusions: From 1999 to 2010, the hospitalization rates of ischemic stroke after AMI decreased overall and for demographic subgroups and those undergoing PCI, CABG, or no revascularization. Declines were seen for all regions, but were consistently higher for stroke belt states. Post-AMI strokes 30-day mortality rates decreased over time.
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Shi, R., Wang, Y., Lichtman, J. H., Krumholz, H. M., Dharmarajan, K., Masoudi, F. A., Dodson, J. A., Chen, J., Chaudhry, S. I., Spertus, J. A., Nallamothu, B. K. Tags: Poster Session II 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

Abstract 232: Parenteral Antihypertensive Use on the First Day of Hospitalization after Acute Ischemic Stroke: A US Population Study Poster Session II
Conclusion: Approximately 16% of AIS patients receive IV AH medication in the first 24 hours of admission in the US. The rate of early AH treatment has increased over time both overall and among those who did not receive rt-PA. Whether this is due to increasingly aggressive BP treatment by physicians or higher BP on admission among AIS patients is unclear. Contrary to recommendations, nicardipine was used infrequently. More evidence is required to justify specific AH agents for BP treatment in AIS.
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Wang, Y., McDonough, E., Adeoye, O., LaPensee, K., Crothers, T. C., Kleindorfer, D. Tags: Poster Session II Source Type: research

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