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Heat Maps of Hypertension, Diabetes Mellitus, and Smoking in the Continental United States Original Articles
Conclusions— Geographic disparities in prevalent hypertension, diabetes mellitus, and smoking exist within states and within counties in the continental United States, and the patterns differ by race.
Source: Circulation: Cardiovascular Quality and Outcomes - January 9, 2017 Category: Cardiology Authors: Loop, M. S., Howard, G., de los Campos, G., Al-Hamdan, M. Z., Safford, M. M., Levitan, E. B., McClure, L. A. Tags: Cardiovascular Disease, Epidemiology, Risk Factors Original Articles Source Type: research

Sex Differences in the Epidemiology of New-Onset In-Hospital Post-Coronary Artery Bypass Graft Surgery Atrial Fibrillation: A Large Multicenter Study Original Articles
Conclusions— These novel data on sex-specific characteristics of new-onset AF after isolated CABG show that women had lower adjusted risk for post-CABG AF and experienced shorter episodes. Investigation of sex-specific impacts on outcomes is needed to identify optimal strategies for prevention and management to ensure all patients achieve the best possible outcomes.
Source: Circulation: Cardiovascular Quality and Outcomes - November 14, 2016 Category: Cardiology Authors: Filardo, G., Ailawadi, G., Pollock, B. D., da Graca, B., Sass, D. M., Phan, T. K., Montenegro, D. E., Thourani, V., Damiano, R. Tags: Atrial Fibrillation, Epidemiology, Women, Cardiovascular Surgery, Revascularization Original Articles Source Type: research

Glycemic Control for Patients With Type 2 Diabetes Mellitus: Our Evolving Faith in the Face of Evidence Original Articles
Conclusions— Discordance exists between the research evidence and academic and clinical policy statements about the value of tight glycemic control to reduce micro- and macrovascular complications. This discordance may distort priorities in the research and practice agendas designed to improve the lives of patients with type 2 diabetes mellitus.
Source: Circulation: Cardiovascular Quality and Outcomes - September 19, 2016 Category: Cardiology Authors: Rodriguez-Gutierrez, R., Montori, V. M. Tags: Complications, Meta Analysis, Quality and Outcomes, Statements and Guidelines Original Articles Source Type: research

Regional Learning Collaboratives Produce Rapid and Sustainable Improvements in Stroke Thrombolysis Times Original Articles
Conclusions— Using a learning collaborative model at Chicago’s 15 primary stroke centers, we observed major reductions in DTN times within 1 quarter of implementation. Regional collaboration and best practices sharing should be a model for rapid and sustainable system-wide quality improvement.
Source: Circulation: Cardiovascular Quality and Outcomes - September 19, 2016 Category: Cardiology Authors: Prabhakaran, S., Lee, J., ONeill, K. Tags: Health Services, Quality and Outcomes, Ischemic Stroke Original Articles Source Type: research

Effects of Vascular and Nonvascular Adverse Events and of Extended-Release Niacin With Laropiprant on Health and Healthcare Costs Original Articles
Conclusions— In HPS2-THRIVE, the addition of extended-release niacin–laropiprant to statin-based therapy reduced quality of life–adjusted survival and increased hospital costs. Clinical Trial Registration— URL: http://clinicaltrials.gov. Unique identifier: NCT00461630.
Source: Circulation: Cardiovascular Quality and Outcomes - July 18, 2016 Category: Cardiology Authors: Kent, S., Haynes, R., Hopewell, J. C., Parish, S., Gray, A., Landray, M. J., Collins, R., Armitage, J., Mihaylova, B., on behalf of the HPS2-THRIVE Collaborative Group Tags: Cardiovascular Disease, Treatment, Cost-Effectiveness, Quality and Outcomes, Vascular Disease Original Articles Source Type: research

Long-Term Persistence of Newly Initiated Warfarin Therapy in Chinese Patients With Nonvalvular Atrial Fibrillation Original Articles
Conclusions— Nonpersistence of warfarin treatment becomes a serious problem for stroke prevention in Chinese patients with nonvalvular AF. Our findings can be used to identify patients who require closer attention or to develop better management strategy for oral anticoagulation therapy.
Source: Circulation: Cardiovascular Quality and Outcomes - July 18, 2016 Category: Cardiology Authors: Wang, Z.-Z., Du, X., Wang, W., Tang, R.-B., Luo, J.-G., Li, C., Chang, S.-S., Liu, X.-H., Sang, C.-H., Yu, R.-H., Long, D.-Y., Wu, J.-H., Bai, R., Liu, N., Ruan, Y.-F., Dong, J.-Z., Ma, C.-S. Tags: Atrial Fibrillation, Compliance/Adherence, Treatment Original Articles Source Type: research

Effectiveness of Left Atrial Appendage Exclusion Procedures to Reduce the Risk of Stroke: A Systematic Review of the Evidence Original Articles
Conclusions— There is limited evidence that the Watchman device may be noninferior to long-term OAC in selected patients. Data on effectiveness of LAA exclusion devices is lacking in patients ineligible for long-term OAC. Percutaneous LAA devices are associated with high rates of procedure-related harms. Although surgical LAA exclusion during heart surgery does not seem to add incremental harm, there is insufficient evidence of benefit.
Source: Circulation: Cardiovascular Quality and Outcomes - July 18, 2016 Category: Cardiology Authors: Noelck, N., Papak, J., Freeman, M., Paynter, R., Low, A., Motuapuaka, M., Kondo, K., Kansagara, D. Tags: Atrial Fibrillation, Anticoagulants, Cardiovascular Surgery, Complications, Ischemic Stroke Original Articles Source Type: research

Use of Contraindicated Antiplatelet Medications in the Setting of Percutaneous Coronary Intervention: Insights From the Veterans Affairs Clinical Assessment, Reporting, and Tracking Program Original Articles
Conclusions— In this national cohort, 18% of patients undergoing PCI had contraindications to common antiplatelet medications. Approximately 6% of those patients received a contraindicated medication with attendant bleeding risk, although this did not translate into significantly higher risk of 30-day mortality. Continued efforts to reduce contraindicated medication use may help avoid periprocedural complications.
Source: Circulation: Cardiovascular Quality and Outcomes - July 18, 2016 Category: Cardiology Authors: Barnes, G. D., Stanislawski, M. A., Liu, W., Baron, A. E., Armstrong, E. J., Ho, P. M., Klein, A., Maddox, T. M., Nallamothu, B. K., Rumsfeld, J. S., Tsai, T. T., Bradley, S. M. Tags: Platelets, Anticoagulants, Percutaneous Coronary Intervention, Stent, Quality and Outcomes Original Articles Source Type: research

Endometriosis and Risk of Coronary Heart Disease Original Articles
Conclusions— In this large, prospective cohort, laparoscopically confirmed endometriosis was associated with increased risk of CHD. The association was strongest among young women. Hysterectomy/oophorectomy was associated with higher risk of CHD and could partially explain the association between endometriosis and CHD.
Source: Circulation: Cardiovascular Quality and Outcomes - May 16, 2016 Category: Cardiology Authors: Mu, F., Rich-Edwards, J., Rimm, E. B., Spiegelman, D., Missmer, S. A. Tags: Cardiovascular Disease, Epidemiology, Risk Factors, Quality and Outcomes Original Articles Source Type: research

Characteristics and Outcomes of Stroke Patients Transferred to Hospitals Participating in the Michigan Coverdell Acute Stroke Registry Original Articles
Conclusions— Transferred patients represent a complex admixture of patient characteristics that result in higher risks of poor outcomes. Our results suggest that it is prudent to account for patient transfer status when comparing hospital outcomes and that stroke registries need to expand their data collection capacity to provide a better understanding of the relative benefits and risks of transferring patients.
Source: Circulation: Cardiovascular Quality and Outcomes - May 16, 2016 Category: Cardiology Authors: Nickles, A. V., Roberts, S., Shell, E., Mitchell, M., Hussain, S., Lyon-Callo, S., Reeves, M. J. Tags: Complications, Mortality/Survival, Quality and Outcomes, Cerebrovascular Disease/Stroke Original Articles Source Type: research

Comparative Effectiveness of Carotid Artery Stenting Versus Carotid Endarterectomy Among Medicare Beneficiaries Original Articles
Conclusions— Outcomes after CAS and CEA among Medicare beneficiaries were comparable after adjusting for both patient- and provider-level factors.
Source: Circulation: Cardiovascular Quality and Outcomes - May 16, 2016 Category: Cardiology Authors: Jalbert, J. J., Nguyen, L. L., Gerhard-Herman, M. D., Kumamaru, H., Chen, C.-Y., Williams, L. A., Liu, J., Rothman, A. T., Jaff, M. R., Seeger, J. D., Benenati, J. F., Schneider, P. A., Aronow, H. D., Johnston, J. A., Brott, T. G., Tsai, T. T., White, C. Tags: Revascularization, Stent, Cerebrovascular Procedures, Stenosis Original Articles Source Type: research

Quantifying Selection Bias in National Institute of Health Stroke Scale Data Documented in an Acute Stroke Registry Original Articles
Conclusions— We demonstrate modest, but important, selection bias in documented NIHSS data, which are missing more often in patients with less severe stroke. The population mean NIHSS score was overestimated by >2 points, which could significantly alter the risk profile of hospitals treating patients with ischemic stroke and subsequent hospital risk–adjusted outcomes.
Source: Circulation: Cardiovascular Quality and Outcomes - May 16, 2016 Category: Cardiology Authors: Thompson, M. P., Luo, Z., Gardiner, J., Burke, J. F., Nickles, A., Reeves, M. J. Tags: Ischemic Stroke Original Articles Source Type: research

Safety and Use of Anticoagulation After Aortic Valve Replacement With Bioprostheses: A Meta-Analysis Original Articles
Conclusions— Contrary to the current guidelines, a meta-analysis of previous studies suggests that anticoagulation in the setting of an aortic bioprosthesis significantly increases bleeding risk without a favorable effect on thromboembolic events. Larger, randomized controlled studies should be performed to further guide this clinical practice.
Source: Circulation: Cardiovascular Quality and Outcomes - May 16, 2016 Category: Cardiology Authors: Riaz, H., Alansari, S. A. R., Khan, M. S., Riaz, T., Raza, S., Luni, F. K., Khan, A. R., Riaz, I. B., Krasuski, R. A. Tags: Anticoagulants, Aortic Valve Replacement/Transcatheter Aortic Valve Implantation Original Articles Source Type: research

Vancouver Transcatheter Aortic Valve Replacement Clinical Pathway: Minimalist Approach, Standardized Care, and Discharge Criteria to Reduce Length of Stay Innovations in Care
We describe the development, implementation, and evaluation of a standardized clinical pathway to facilitate safe discharge home at the earliest time after transfemoral transcatheter aortic valve replacement. Between May 2012 and October 2014, the Heart Team developed a clinical pathway suited to the unique requirements of transfemoral transcatheter aortic valve replacement in contemporary practice. The components included risk-stratified minimalist periprocedure approach, standardized postprocedure care with early mobilization and reconditioning, and criteria-driven discharge home. Our aim was to reduce variation in care,...
Source: Circulation: Cardiovascular Quality and Outcomes - May 16, 2016 Category: Cardiology Authors: Lauck, S. B., Wood, D. A., Baumbusch, J., Kwon, J.-Y., Stub, D., Achtem, L., Blanke, P., Boone, R. H., Cheung, A., Dvir, D., Gibson, J. A., Lee, B., Leipsic, J., Moss, R., Perlman, G., Polderman, J., Ramanathan, K., Ye, J., Webb, J. G. Tags: Treatment, Quality and Outcomes Innovations in Care Source Type: research

Dabigatran Versus Warfarin for Atrial Fibrillation in Real-World Clinical Practice: A Systematic Review and Meta-Analysis Original Articles
Conclusions— In real-world clinical practice, dabigatran is comparable with warfarin in preventing ischemic stroke among patients with nonvalvular atrial fibrillation. However, dabigatran is associated with a lower risk for intracranial bleeding relative to warfarin, but—particularly among the elderly—a greater risk for gastrointestinal bleeding. Bleeding outcomes from observational studies are consistent with those from the pivotal Randomized Evaluation of Long-Term Anticoagulation Therapy trial.
Source: Circulation: Cardiovascular Quality and Outcomes - March 15, 2016 Category: Cardiology Authors: Romanelli, R. J., Nolting, L., Dolginsky, M., Kym, E., Orrico, K. B. Tags: Meta Analysis, Ischemic Stroke Original Articles Source Type: research

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