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Abstract 6: Treatment Effect of Clopidogrel Plus Aspirin Within 12 Hours of Acute Minor Stroke or TIA Session Title: Abstract Oral Session: Outcomes
Conclusions: Among patients treated within 12 hours, the combination of clopidogrel and aspirin was more effective than aspirin alone in reducing the risk of recurrent ischemic stroke during the 90-day follow-up and did not increase the hemorrhagic risk. The higher ischemic stroke rate in the initial hours after stroke supports early more aggressive antiplatelet therapy.Clinical Trial Registration-URL: http//www.clinicaltrials.gov. Unique identifier: NCT00979589.
Source: Circulation: Cardiovascular Quality and Outcomes - February 26, 2016 Category: Cardiology Authors: Li, Z., Wang, Y., Zhao, X., Liu, L., Xian, Y., Johnston, S. C., Wang, Y., the CHANCE Investigators Tags: Session Title: Abstract Oral Session: Outcomes Source Type: research

Abstract 10: Pre-stroke Antithrombotic Therapy and Stroke Severity in Acute Ischemic Stroke Patients with Atrial Fibrillation Session Title: Abstract Oral Session: Outcomes
Conclusions: A majority of AF patients presenting with AIS are not on guideline recommended anticoagulation or are not therapeutic on their anticoagulation. Even when strokes occurred on therapeutic warfarin or a NOAC, the strokes were less severe. These findings highlight the huge opportunities to further improve proper use of oral anticoagulants in eligible AF patients.
Source: Circulation: Cardiovascular Quality and Outcomes - February 26, 2016 Category: Cardiology Authors: Xian, Y., OBrien, E. C., Liang, L., Pencina, M. J., Schwamm, L. H., Fonarow, G. C., Bhatt, D. L., Smith, E. E., Maisch, L., Hannah, D., Lindholm, B., Lytle, B. L., Hernandez, A. F., Peterson, E. D. Tags: Session Title: Abstract Oral Session: Outcomes 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 102: Effects of Proprioceptive Neuromuscular Facilitation Exercises on Upper Extremity Function in the Patients With Acute Stroke Session Title: Abstract Poster Session I and Reception
Conclusion: Proprioceptive neuromuscular facilitation exercises are very effective in generating voluntary control and improving functional activities of daily living if given from the first day of stroke. For improvement in arm function the intervention should be started first from scapula. Due to the irradiation effect, there is generation and improvement of tone and power in upper extremity.Acknowledgements: This study was supported by the department of Science and Technology, New Delhi, India.
Source: Circulation: Cardiovascular Quality and Outcomes - February 26, 2016 Category: Cardiology Authors: Chaturvedi, P., Singh, A. K., Kulshreshtha, D., Maurya, P. K., Thacker, A. K. Tags: Session Title: Abstract Poster Session I and Reception Source Type: research

Abstract 240: Regional Variation in 30-Day Ischemic Stroke Mortality and Readmissions in Get With the Guidelines-Stroke Hospitals Session Title: Abstract Poster Session II
Conclusions: HRR-level 30-day ischemic stroke mortality and readmission rates exhibit substantial regional variation and are inversely correlated. Further research is ongoing to determine the origin of the regional variation and correlation between 30-day event rates.
Source: Circulation: Cardiovascular Quality and Outcomes - February 26, 2016 Category: Cardiology Authors: Thompson, M. P., Zhao, X., Bekelis, K., Gottlieb, D. J., Fonarow, G. C., Schulte, P. J., Schwamm, L. H., Smith, E. E., Reeves, M. J. Tags: Session Title: Abstract Poster Session II 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

Improving Anticoagulation Measurement: Novel Warfarin Composite Measure Original Articles
Conclusions— WCM produces the largest range of risk for warfarin complications, widening the floor ceiling effects that limit the use of TTR and INR variability as separate measures. Anticoagulation clinics ranking changed considerably according to the anticoagulation measure that was selected.
Source: Circulation: Cardiovascular Quality and Outcomes - November 17, 2015 Category: Cardiology Authors: Razouki, Z., Burgess, J. F., Ozonoff, A., Zhao, S., Berlowitz, D., Rose, A. J. Tags: Anticoagulants, Ethics and Policy, Cerebrovascular Disease/Stroke, Thrombosis Original Articles Source Type: research

Acute Stroke: Shifting From Informed Consent to Informed Refusal of Intravenous Tissue-Type Plasminogen Activator Editorial
Source: Circulation: Cardiovascular Quality and Outcomes - October 29, 2015 Category: Cardiology Authors: Schwamm, L. H. Tags: Ethics and Policy, Quality and Outcomes, Cerebrovascular Disease/Stroke, Ischemic Stroke Editorial Source Type: research

Smoking Paradox in Patients Hospitalized With Coronary Artery Disease or Acute Ischemic Stroke: Findings From Get With The Guidelines Original Articles
Conclusions— Among patients hospitalized with CAD and AIS, smoking is a risk factor for early age of onset, even among those with few vascular risk factors. The persistent association with lower in-hospital mortality after adjusted and stratified analyses probably represents residual unmeasured confounding, although a biological effect of smoking cannot be excluded. Further clinical and prospective population-based studies are needed to explore variables that contribute to outcomes in these patients.
Source: Circulation: Cardiovascular Quality and Outcomes - October 29, 2015 Category: Cardiology Authors: Ali, S. F., Smith, E. E., Reeves, M. J., Zhao, X., Xian, Y., Hernandez, A. F., Bhatt, D. L., Fonarow, G. C., Schwamm, L. H. Tags: Myocardial Infarction, Cerebrovascular Disease/Stroke, Ischemic Stroke, Acute Coronary Syndromes Original Articles Source Type: research

Variation and Trends in the Documentation of National Institutes of Health Stroke Scale in GWTG-Stroke Hospitals Original Articles
Conclusions— Documentation of NIHSS is higher in patients who are thrombolysis candidates. Evidence of modest bias in NIHSS scores was observed but this has lessened as the documentation of NIHSS has improved in recent years.
Source: Circulation: Cardiovascular Quality and Outcomes - October 29, 2015 Category: Cardiology Authors: Reeves, M. J., Smith, E. E., Fonarow, G. C., Zhao, X., Thompson, M., Peterson, E. D., Schwamm, L. H., Olson, D. Tags: Cerebrovascular Disease/Stroke Original Articles Source Type: research

Patient-Centered Decision Support in Acute Ischemic Stroke: Qualitative Study of Patients' and Providers' Perspectives Original Articles
Conclusions— This study suggests that a positively framed risk–benefit tool with graphical presentations of general and patient-specific risk estimates could support patients and providers in considering r-tPA for acute ischemic stroke. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT01864928.
Source: Circulation: Cardiovascular Quality and Outcomes - October 29, 2015 Category: Cardiology Authors: Decker, C., Chhatriwalla, E., Gialde, E., Garavalia, B., Summers, D., Quinlan, M. E., Cheng, E., Rymer, M., Saver, J. L., Chen, E., Kent, D. M., Spertus, J. A. Tags: Cardiopulmonary Resuscitation and Emergency Cardiac Care Original Articles 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

Care Trajectories of Veterans in the 12 Months After Hospitalization for Acute Ischemic Stroke Original Articles
Conclusions— Care trajectories after stroke were associated with stroke severity and functional dependency and they had a dramatic impact on subsequent costs.
Source: Circulation: Cardiovascular Quality and Outcomes - October 29, 2015 Category: Cardiology Authors: Arling, G., Ofner, S., Reeves, M. J., Myers, L. J., Williams, L. S., Daggy, J. K., Phipps, M. S., Chumbler, N., Bravata, D. M. Tags: Ethics and Policy, Cerebrovascular Disease/Stroke Original Articles Source Type: research

Does the Volume of Ischemic Stroke Admissions Relate to Clinical Outcomes in the Ontario Stroke System? Original Articles
Conclusions— Hospital IS volume is associated with 30-day mortality in Ontario. Patients admitted to hospitals with annual IS volumes <126 annually are more likely to die within 30 days than patients admitted to hospitals that see on average 300 patients annually. This finding supports centralizing care in stroke-specialized hospitals.
Source: Circulation: Cardiovascular Quality and Outcomes - October 29, 2015 Category: Cardiology Authors: Hall, R. E., Fang, J., Hodwitz, K., Saposnik, G., Bayley, M. T. Tags: Ethics and Policy, Health Services, Quality and Outcomes, Ischemic Stroke Original Articles Source Type: research

Academic-Community Hospital Comparison of Vulnerabilities in Door-to-Needle Process for Acute Ischemic Stroke Original Articles
Conclusions— Although the identification of common critical failures suggests opportunities for a generalizable process redesign, differences in the criticality and nature of failures must be addressed at the individual hospital level, to develop robust and sustainable solutions to reduce DTN time.
Source: Circulation: Cardiovascular Quality and Outcomes - October 29, 2015 Category: Cardiology Authors: Prabhakaran, S., Khorzad, R., Brown, A., Nannicelli, A. P., Khare, R., Holl, J. L. Tags: Treatment, Ethics and Policy, Ischemic Stroke Original Articles Source Type: research

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