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Abstract 205: Stroke Risk and Symptom Recognition Post Cardiac Catheterization Session Title: Poster Session PM
Over 1.4 million cardiac catheterization procedures (CCPs) take place yearly. CPP related stroke incidence in 1973 was reported as 0.23%. CCPs are invasive in nature with complications occurring due to unintentional trauma to preexisting atherosclerotic aortic plaques or thrombus formation at catheter/guidewire tips. Less common causes of ischemic stroke are air, left ventricular clot, hypotension, arterial dissection, fractured guidewire. Transient neurological deficits have been reported following high-osmolar contrast injection into carotid/vertebral arteries. With improved practice, current stroke incidence is 0.06%. P...
Source: Circulation: Cardiovascular Quality and Outcomes - April 5, 2018 Category: Cardiology Authors: Rivet, C., Schaefer, K., Strom, C. Tags: Session Title: Poster Session PM Source Type: research

Development and Validation of Electronic Quality Measures to Assess Care for Patients With Transient Ischemic Attack and Minor Ischemic Stroke Original Articles
Conclusions— It is feasible to construct valid eQMs for processes of transient ischemic attack and minor ischemic stroke care. Healthcare systems with EHRs should consider using electronic data to evaluate care for their patients with transient ischemic attack and to complement and expand quality measurement programs currently focused on patients with stroke.
Source: Circulation: Cardiovascular Quality and Outcomes - September 14, 2017 Category: Cardiology Authors: Bravata, D. M., Myers, L. J., Cheng, E., Reeves, M., Baye, F., Yu, Z., Damush, T., Miech, E. J., Sico, J., Phipps, M., Zillich, A., Johanning, J., Chaturvedi, S., Austin, C., Ferguson, J., Maryfield, B., Snow, K., Ofner, S., Graham, G., Rhude, R., William Tags: Quality and Outcomes, Transient Ischemic Attack (TIA) Original Articles Source Type: research

Abstract 016: Endovascular Management of Major Vascular Access Site Complications During Transcatheter Aortic Valve Implantation (TAVI). Session Title: Poster Session I
Conclusion: Many patients with major vascular complications during TAVI can be treated with a pure endovascular approach. In our small series we observed no difference in concurrent complications when an endovascular repair can be rapidly initiated as compared to a primary surgical approach.
Source: Circulation: Cardiovascular Quality and Outcomes - March 31, 2017 Category: Cardiology Authors: Majeed, M. U., Green, K. D., Fudim, M., Robbins, M. A., Zhao, D. X. Tags: Session Title: Poster Session I Source Type: research

Abstract 122: Quality of Care for Patients With Acute Ischemic Stroke as a Function of Hospital Intravenous Thrombolysis With Recombinant Tissue Plasminogen Activator Capability: Insights From China National Stroke Registry II Session Title: Poster Session I
Conclusions: The CNSR II hospitals were associated with better performance in some of the hospitals but not all of them. The difference in conformity between rt-PA-capable hospitals and rt-PA-incapable hospitals was modest for performance measures of stroke care. However, more room for improvement still exists in key quality performance measures and further studies should be explored.
Source: Circulation: Cardiovascular Quality and Outcomes - March 31, 2017 Category: Cardiology Authors: Rao, Z., Li, Z., Gu, H., Wang, Y., Wang, Y. Tags: Session Title: Poster Session I Source Type: research

Abstract 159: Evaluation of Clinical Outcomes among Nonvalvular Atrial Fibrillation Patients Treated With Warfarin or Rivaroxaban Stratified by Presence or Absence of CKD in a Claims Database Session Title: Poster Session II
Conclusions: This study suggests that, in an adult population with NVAF, rivaroxaban-treated patients had fewer ischemic strokes across all patients, including patients with renal impairment. Rivaroxaban-treated patients also had significantly better outcomes for the composite (VTE, MI, or stroke) measure across all groups. Bleeding rates were comparable across all groups.
Source: Circulation: Cardiovascular Quality and Outcomes - March 31, 2017 Category: Cardiology Authors: Weir, M. R., Haskell, L., Berger, J. S., Ashton, V., Laliberte, F., Crivera, C., Brown, K., Lefebvre, P., Schein, J. Tags: Session Title: Poster Session II Source Type: research

Abstract 160: Impact of Medication Adherence on Risk of Stroke, Major Bleeding and Other Outcomes in Atrial Fibrillation Patients Using Novel Oral Anticoagulants (Dabigatran and Rivaroxaban) Session Title: Poster Session II
Conclusion: In our sample, adherence to NOACs was associated with a reduction in stroke and DVTPE risk but did not substantially increase bleeding risk. Further studies with newer NOACs are warranted.
Source: Circulation: Cardiovascular Quality and Outcomes - March 31, 2017 Category: Cardiology Authors: Deshpande, C. G., Willey Temkin, C., Laforge, R., Kogut, S. Tags: Session Title: Poster Session II 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

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

Reimagining Anticoagulation Clinics in the Era of Direct Oral Anticoagulants Cardiovascular Perspective
Anticoagulation clinics were initially developed to provide safe and effective care for warfarin-treated patients with atrial fibrillation, venous thromboembolism, and mechanical valve replacement. Traditionally, these patients required ongoing laboratory monitoring and warfarin dose adjustment by expert providers. With the introduction of direct oral anticoagulants (dabigatran, rivaroxaban, apixaban, and edoxaban), many have questioned the need for anticoagulation clinic. However, we think that the growing number of oral anticoagulant choices creates an urgent need for expanding the traditional role of the anticoagulation...
Source: Circulation: Cardiovascular Quality and Outcomes - March 15, 2016 Category: Cardiology Authors: Barnes, G. D., Nallamothu, B. K., Sales, A. E., Froehlich, J. B. Tags: Atrial Fibrillation, Ethics and Policy, Health Services, Ischemic Stroke, Thrombosis Cardiovascular Perspective Source Type: research

Abstract 12: Heart Failure Medications Prescribed at Discharge for Patients With Left Ventricular Assist Devices Session Title: Abstract Oral Session: Quality of Care
Conclusion: Traditional HF therapies are commonly prescribed to LVAD recipients, although less frequently than to advanced HF patients without LVAD support. Aldosterone antagonists are prescribed increasingly to LVAD patients. Further research is needed on the optimal medical regimen for patients with LVADs.
Source: Circulation: Cardiovascular Quality and Outcomes - February 26, 2016 Category: Cardiology Authors: Baras Shreibati, J., Sheng, S., Fonarow, G. C., DeVore, A. D., Yancy, C. W., Bhatt, D. L., Peterson, E. D., Hernandez, A., Heidenreich, P. A. Tags: Session Title: Abstract Oral Session: Quality of Care Source Type: research

Abstract 201: Are Patients With Atrial Fibrillation Willing to Consider New Strategies to Prevent Stroke? A Qualitative Analysis of Community-Based Focus Groups Session Title: Abstract Poster Session II
Conclusion: Focus group participants expressed a fear of debilitating stroke, with varying levels of acceptance of inconveniences and potential bleeding associated with blood thinners. Among a subset of participants, there was willingness to consider new stroke prevention therapies; however, this was preferred with a known, trusted physician. Subspecialized clinicians offering new therapies may be challenged to establish perceived mutual respect with patients, traditionally built over time, and this may be required for patients to consider new therapies. Future research is needed to determine best practices for both establ...
Source: Circulation: Cardiovascular Quality and Outcomes - February 26, 2016 Category: Cardiology Authors: ONeill, E. S., Grande, S. W., Coylewright, 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

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

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

Clinical Prediction Models for Cardiovascular Disease: Tufts Predictive Analytics and Comparative Effectiveness Clinical Prediction Model Database Original Articles
Conclusions— There is an abundance of CPMs available for a wide assortment of cardiovascular disease conditions, with substantial redundancy in the literature. The comparative performance of these models, the consistency of effects and risk estimates across models and the actual and potential clinical impact of this body of literature is poorly understood.
Source: Circulation: Cardiovascular Quality and Outcomes - July 21, 2015 Category: Cardiology Authors: Wessler, B. S., Lai YH, L., Kramer, W., Cangelosi, M., Raman, G., Lutz, J. S., Kent, D. M. Tags: Congestive, Risk Factors Original Articles Source Type: research

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