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Validity of Claims-Based Stroke Algorithms in Contemporary Medicare Data: Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study Linked With Medicare Claims Methods Paper
Conclusions— Claims-based algorithms to identify stroke in a contemporary Medicare cohort had high positive predictive value and specificity, supporting their use as outcomes for etiologic and comparative effectiveness studies in similar populations. These inpatient algorithms are unsuitable for estimating stroke incidence because of low sensitivity.
Source: Circulation: Cardiovascular Quality and Outcomes - July 15, 2014 Category: Cardiology Authors: Kumamaru, H., Judd, S. E., Curtis, J. R., Ramachandran, R., Hardy, N. C., Rhodes, J. D., Safford, M. M., Kissela, B. M., Howard, G., Jalbert, J. J., Brott, T. G., Setoguchi, S. Tags: Health policy and outcome research, Acute Cerebral Hemorrhage, Acute Cerebral Infarction Methods Paper Source Type: research

Abstract 261: Applying Clinical Trial Data to Real-World: Apixaban, Dabigatran, and Rivaroxaban Session Title: Poster Session II
CONCLUSIONS: If relative risk reductions from randomized clinical trials persist in the real-world, apixaban would result in the greatest clinical benefit versus warfarin of all NOACs in terms of stroke and major bleeding excluding intracranial hemorrhage events avoided.
Source: Circulation: Cardiovascular Quality and Outcomes - June 2, 2014 Category: Cardiology Authors: Amin, A., Stokes, M., Wu, N., Gatt, E., Makenbaeva, D., Wiederkehr, D., Lawrence, J. H. Tags: Session Title: Poster Session II Source Type: research

Abstract 314: Impact of Spontaneous Bleeding Events on Health State Utility in Patients with Atrial Fibrillation: Results from the ENGAGE AF-TIMI 48 Trial Session Title: Poster Session III
CONCLUSION: Spontaneous bleeding events are associated with a negative impact on health state utility, with greatest immediate impact for major bleeds. Health state utility remains low 1 year after an ICH, but gradually returns to baseline 1-year after other major bleeding events. Future cost-effectiveness analysis of strategies to prevent stroke in AF should consider both the economic and health status impact of bleeding events to inform health care decision making.
Source: Circulation: Cardiovascular Quality and Outcomes - June 2, 2014 Category: Cardiology Authors: Magnuson, E. A., Wang, K., Li, H., Kwong, W. J., Antman, E. M., Ruff, C. T., Murphy, S. A., Giugliano, R. P., Cohen, D. J. Tags: Session Title: Poster Session III Source Type: research

Abstract 7: Risk of Intracranial Hemorrhage Among Acute Ischemic Stroke Patients Receiving Prior Antiplatelet Therapy and Treated with Intravenous Tissue Plasminogen Activator Session Title: Concurrent I Session B: Oral Abstracts on Stroke Topics
Conclusion: This study represents the largest clinical experience of the safety of thrombolysis in patients on prior antiplatelet therapy. Despite a higher incidence of sICH, the absolute excess risk appears small (0.67%). These findings support current guideline recommendations regarding use of intravenous tPA in patients on antiplatelet therapy with careful weighing of potential risk and benefit.
Source: Circulation: Cardiovascular Quality and Outcomes - June 2, 2014 Category: Cardiology Authors: Xian, Y., Grau-Spulveda, M., Schwamm, L. H., Bhatt, D. L., Smith, E. E., Reeves, M. J., Federspiel, J., Thomas, L., Bettger, J. P., Laskowitz, D. T., Hernandez, A. F., Fonarow, G. C., Peterson, E. D. Tags: Session Title: Concurrent I Session B: Oral Abstracts on Stroke Topics 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

ICD9 Codes Cannot Reliably Identify Hemorrhagic Transformation of Ischemic Stroke Data Report
Source: Circulation: Cardiovascular Quality and Outcomes - July 16, 2013 Category: Cardiology Authors: Mullen, M. T., Moomaw, C. J., Alwell, K., Khoury, J. C., Kissela, B. M., Woo, D., Flaherty, M. L., Khatri, P., Adeoye, O., Ferioli, S., Kleindorfer, D. Tags: Health policy and outcome research, Acute Cerebral Infarction Data Report Source Type: research

Patterns of Emergency Medical Services Use and Its Association With Timely Stroke Treatment: Findings From Get With the Guidelines-Stroke Original Articles
Conclusions— Although EMS use is independently associated with more rapid evaluation and treatment of stroke, more than one third of stroke patients fail to use EMSs. Interventions aimed at increasing EMS activation should target populations at risk, particularly younger patients and those of minority race and ethnicity.
Source: Circulation: Cardiovascular Quality and Outcomes - May 21, 2013 Category: Cardiology Authors: Ekundayo, O. J., Saver, J. L., Fonarow, G. C., Schwamm, L. H., Xian, Y., Zhao, X., Hernandez, A. F., Peterson, E. D., Cheng, E. M. Tags: Emergency treatment of Stroke Original Articles Source Type: research

Abstract 10: Contraindications to Oral Anticoagulation in the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF) Concurrent I Session B: Oral Abstract Presentations on Stroke Topics
Conclusions. Contraindications to OAC therapy among AF patients are common and often due to high bleeding risk. Furthermore, many patients with reported contraindications are taking warfarin, suggesting that many contraindications to warfarin therapy are minor, relative, or temporary.
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: O'Brien, E. C., Holmes, D., Koller, C. R., Singer, D. E., Ansell, J., Allen, L. A., Hylek, E. M., Kowey, P., Gersh, B., Fonarow, G. C., Mahaffey, K. W., Chang, P., Ezekowitz, M. D., Peterson, E. D., Piccini, J. P. Tags: Concurrent I Session B: Oral Abstract Presentations on Stroke Topics Source Type: research

Abstract 25: Predicting Outcomes among Patients with Heart Failure Receiving Anticoagulation with Warfarin Concurrent III Session A: Oral Abstract Presentations on EHS & Health IT
Conclusion: We developed a composite score for CHF severity which predicted both anticoagulation control and the rate of major hemorrhage among patients anticoagulated with warfarin. This study suggests that relatively easily observable characteristics can be used to risk-stratify patients with CHF who are receiving anticoagulation for AF.
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Kim, E.-J., Rose, 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 156: Body Mass Index and Outcomes among Patients with Atrial Fibrillation from the ATRIA2-CVRN Study Poster Session II
In conclusion, overweight and moderate obesity appear protective for all-cause mortality in at-risk AF patients during off-warfarin periods, but these effects do not appear to be mediated by reduced risk of thromboembolism or major bleeding.
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Black, M. H., Wu, J., Singer, D. E., Udaltsova, N., Harrison, T. N., Shen, A. Y.-J., Fang, M. C., Go, A. S., Reynolds, K. Tags: Poster Session II Source Type: research

Abstract 208: A Literature Review Of Indirect Cost Of Stroke Poster Session II
Conclusions: While the literature indicated that the indirect cost accounted for a significant portion of the economic burden of stroke, there is a clear need to develop improved methods to study costs and to better use or establish relevant data sources for such studies. With the aging population and increasing survival rate of stroke, both direct and indirect costs of stroke are likely to increase greatly. Interventions for stroke prevention as well as for improving quality of life among stroke patients are needed to contain both direct and indirect costs associated with stroke. More research investigating the indirect c...
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Joo, H., George, M. G., Fang, J., Wang, G. 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 212: Estimation Of Long-term Care Needs For Stroke By Integrating Functional Disability And Survival Poster Session II
Conclusions: Among different subtypes of stroke, cardio-embolic infarct suffered the longest duration of physical functional disability related to self-care. The method can also be employed to other chronic diseases with different types of functional disabilities.
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Hung, M.-C., Hsieh, C.-L., Hwang, J.-S., Jeng, J.-S., Wang, J.-D. Tags: Poster Session II Source Type: research

Abstract 217: How well does the CHADS2 Stroke Risk Score Predict Major Hemorrhage in Patients with Atrial Fibrillation? Poster Session II
Conclusions: Although some clinical markers of stroke risk such as those included in the CHADS2 risk score are also associated with increased hemorrhage risk, the CHADS2 risk score should not be used instead of a validated hemorrhage risk tool to estimate hemorrhage risk.
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Quinn, G. R., Singer, D. E., Go, A. S., Chang, Y., Borowsky, L., Pomernacki, N., Udaltsova, N., Fang, M. C. Tags: Poster Session II Source Type: research

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