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Certain Uncertainty: Life After Stroke From the Patient's Perspective Patient Viewpoints
Source: Circulation: Cardiovascular Quality and Outcomes - November 18, 2014 Category: Cardiology Authors: Hannah, D., Lindholm, B., Maisch, L. Tags: Health policy and outcome research, Acute Cerebral Infarction Patient Viewpoints Source Type: research

Clinical Commentary on "Certain Uncertainty: Life After Stroke From the Patient's Perspective" Patient Viewpoints
Source: Circulation: Cardiovascular Quality and Outcomes - November 18, 2014 Category: Cardiology Authors: O'Brien, E. C., Xian, Y., Fonarow, G. C., Olson, D. M., Schwamm, L. H., Hernandez, A. F. Tags: Health policy and outcome research, Acute Cerebral Infarction Patient Viewpoints Source Type: research

Improving Quality Measurement for Anticoagulation: Adding International Normalized Ratio Variability to Percent Time in Therapeutic Range Original Articles
Conclusions— Unstable anticoagulation predicts warfarin adverse effects independent of TTR. Moreover, knowledge about anticoagulation stability further stratifies the risk for adverse events at given levels of TTR.
Source: Circulation: Cardiovascular Quality and Outcomes - September 16, 2014 Category: Cardiology Authors: Razouki, Z., Ozonoff, A., Zhao, S., Jasuja, G. K., Rose, A. J. Tags: Coagulation, Coumarins, Thrombosis risk factors, Embolic stroke, Anticoagulants Original Articles Source Type: research

Integrating Real-Time Clinical Information to Provide Estimates of Net Clinical Benefit of Antithrombotic Therapy for Patients With Atrial Fibrillation Original Articles
Conclusions— Use of a decision support tool that integrates patient-specific stroke and bleeding risk could result in significant gains in quality-adjusted life expectancy for a primary care population of patients with atrial fibrillation.
Source: Circulation: Cardiovascular Quality and Outcomes - September 16, 2014 Category: Cardiology Authors: Eckman, M. H., Wise, R. E., Speer, B., Sullivan, M., Walker, N., Lip, G. Y. H., Kissela, B., Flaherty, M. L., Kleindorfer, D., Khan, F., Kues, J., Baker, P., Ireton, R., Hoskins, D., Harnett, B. M., Aguilar, C., Leonard, A., Prakash, R., Arduser, L., Cost Tags: Health policy and outcome research, Primary prevention, Coumarins, Thrombosis risk factors, Arrhythmias, clinical electrophysiology, drugs, Anticoagulants, Epidemiology Original Articles Source Type: research

Assessment of the Completeness and Accuracy of Case Ascertainment in the Michigan Stroke Registry Original Articles
Conclusions— Among registry hospitals, these results revealed relatively high levels of completeness and accuracy. Matching registry data to hospital discharge data identified hospitals that changed their case ascertainment method to a case sampling approach. This study illustrates the value of monitoring case ascertainment in stroke registries using external data sources.
Source: Circulation: Cardiovascular Quality and Outcomes - September 16, 2014 Category: Cardiology Authors: Reeves, M. J., Nickles, A. V., Roberts, S., Hurst, R., Lyon-Callo, S. Tags: Health policy and outcome research, Acute Cerebral Infarction, Other Stroke Treatment - Medical Original Articles Source Type: research

Get With The Guidelines AFIB: Novel Quality Improvement Registry for Hospitalized Patients With Atrial Fibrillation Methods Paper
Conclusions— AF is common clinical problem with significant morbidity and mortality. Get With The Guidelines-AFIB is a national hospital-based AF quality improvement program designed to increase adherence to evidence-based guidelines for AF.
Source: Circulation: Cardiovascular Quality and Outcomes - September 16, 2014 Category: Cardiology Authors: Lewis, W. R., Piccini, J. P., Turakhia, M. P., Curtis, A. B., Fang, M., Suter, R. E., Page, R. L., Fonarow, G. C. Tags: Health policy and outcome research, Other anticoagulants, Arrhythmias, clinical electrophysiology, drugs Methods Paper Source Type: research

Quality-of-Life Outcomes With a Disodium EDTA Chelation Regimen for Coronary Disease: Results From the Trial to Assess Chelation Therapy Randomized Trial Original Articles
Conclusions— In stable, predominantly asymptomatic coronary disease patients with a history of myocardial infarction, EDTA chelation therapy did not have a detectable effect on QOL during 2 years of follow-up. Clinical Trial Registration— URL: http://clinicaltrials.gov. Unique identifier: NCT00044213.
Source: Circulation: Cardiovascular Quality and Outcomes - July 15, 2014 Category: Cardiology Authors: Mark, D. B., Anstrom, K. J., Clapp-Channing, N. E., Knight, J. D., Boineau, R., Goertz, C., Rozema, T. C., Liu, D. M., Nahin, R. L., Rosenberg, Y., Drisko, J., Lee, K. L., Lamas, G. A., on behalf of the TACT Investigators Tags: Other Treatment Original Articles Source Type: research

Nonsteroidal Anti-Inflammatory Drugs and Cardiovascular Outcomes in Women: Results From the Women's Health Initiative Original Articles
Conclusions— Regular use of selective cox-2 inhibitors and nonselective NSAIDs with cox-2>cox-1 inhibition showed a modestly increased hazard for cardiovascular events. Nonselective agents with cox-1>cox-2 inhibition were not associated with increased cardiovascular risk. Clinical Trial Registration— URL: www.clinicaltrials.gov. Unique identifier: NCT00000611.
Source: Circulation: Cardiovascular Quality and Outcomes - July 15, 2014 Category: Cardiology Authors: Bavry, A. A., Thomas, F., Allison, M., Johnson, K. C., Howard, B. V., Hlatky, M., Manson, J. E., Limacher, M. C. Tags: Risk Factors Original Articles Source Type: research

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 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 8: Association Between Hospital "Get With The Guidelines-Stroke" Performance Measures And Outcomes Among Patients With Acute Ischemic Stroke In China Session Title: Concurrent I Session B: Oral Abstracts on Stroke Topics
Conclusions: A significant association between hospital care process and outcomes was found, supporting the use of GWTG-Stroke performance metrics as a means of assessing and helping improve stroke care quality in China.
Source: Circulation: Cardiovascular Quality and Outcomes - June 2, 2014 Category: Cardiology Authors: Li, Z., Wang, Y., Wang, Y., Zhao, X., Wang, C., Liu, L., Wang, C., Zhang, C., Pan, Y., Yang, X. Tags: Session Title: Concurrent I Session B: Oral Abstracts on Stroke Topics 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

Abstract 10: Predictors of Poor Outcome in Acute Ischemic Stroke Patients after Successful Recanalization Session Title: Concurrent I Session B: Oral Abstracts on Stroke Topics
Conclusions: Age, occlusion site, high NIHSS, diabetes, not receiving IV t-PA, use of rescue therapy and three or more passes, were associated with poor 90-day outcome despite successful recanalization.
Source: Circulation: Cardiovascular Quality and Outcomes - June 2, 2014 Category: Cardiology Authors: Starosciak, A. K., Linfante, I., Walker, G., Zaidat, O. O., Castonguay, A. C., Lin, E., Dabus, G., NASA Investigators Tags: Session Title: Concurrent I Session B: Oral Abstracts on Stroke Topics Source Type: research

Abstract 11: Temporal Changes in NIHSS Documentation and Stroke Severity among Patients Treated with Thrombolysis in the Massachusetts Coverdell Registry Session Title: Concurrent I Session B: Oral Abstracts on Stroke Topics
Discussion: IV tPA use in MA Coverdell patients is increasing and now reaches 25% of all early arriving subjects. NIHSS documentation is increasing as well, especially among subjects with lower NIHSS scores. The median NIHSS in RISS or Too Mild patients is reassuringly low, and decreased significantly among Too Mild patients. These data, coupled with the fact that unadjusted rates of discharge home among IV tPA patients are increasing while severity-adjusted rates are not, suggests that more patients previously felt to be Too Mild are now receiving IV tPA. Further efforts are still warranted.
Source: Circulation: Cardiovascular Quality and Outcomes - June 2, 2014 Category: Cardiology Authors: Schwamm, L., Parkinson, G., Coe, L. Tags: Session Title: Concurrent I Session B: Oral Abstracts on Stroke Topics Source Type: research

Abstract 12: Accuracy and Validation of an Automated Electronic Medical Record Algorithm to Identify Patients with Atrial Fibrillation at Risk for Stroke Session Title: Concurrent I Session B: Oral Abstracts on Stroke Topics
Discussion: Automated methods can be used to identify patients with prevalent AF indicated for anticoagulation, but may suffer from misclassification of up to 12%. Misclassification is minimized by requiring a diagnosis of AF within the prior year and using a CHA2DS2-Vasc based algorithm. Despite differences in accuracy between definitions, system-wide anticoagulation rates assessed using these definitions were similar. The diagnosis codes validated in this study can be applied for internal quality improvement and observational studies, and might be adapted for use in nationwide quality reporting programs.
Source: Circulation: Cardiovascular Quality and Outcomes - June 2, 2014 Category: Cardiology Authors: Navar-Boggan, A. M., Rymer, J., Piccini, J. P., Shatila, W., Ring, L., Stafford, J., Al-Khatib, S. M., Peterson, E. Tags: Session Title: Concurrent I Session B: Oral Abstracts on Stroke Topics Source Type: research

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