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Importance of Considering Competing Risks in Time-to-Event Analyses: Application to Stroke Risk in a Retrospective Cohort Study of Elderly Patients With Atrial Fibrillation Original Articles
Conclusions: The incidence of death without stroke was 9-fold higher than that of stroke, leading to biased estimates of stroke risk with traditional time-to-event methods. Statistical methods that appropriately account for competing risks should be used to mitigate this bias.
Source: Circulation: Cardiovascular Quality and Outcomes - July 11, 2018 Category: Cardiology Authors: Abdel-Qadir, H., Fang, J., Lee, D. S., Tu, J. V., Amir, E., Austin, P. C., Anderson, G. M. Tags: Atrial Fibrillation, Epidemiology, Primary Prevention, Cerebrovascular Disease/Stroke Original Articles Source Type: research

Increasing Use of Anticoagulants in Germany and Its Impact on Hospitalization for Intracranial Bleeding Data Report
Source: Circulation: Cardiovascular Quality and Outcomes - May 10, 2018 Category: Cardiology Authors: Gulker, J.-E., Kroger, K., Kowall, B., Dingelstadt, M., Stang, A. Tags: Atrial Fibrillation, Meta Analysis, Quality and Outcomes, Cerebrovascular Disease/Stroke, Intracranial Hemorrhage Data Report Source Type: research

Abstract 267: A Single-page Best Practice Algorithm Reduces Stroke Risk and Improves Arrhythmia Management Decisions in Patients With Acute Atrial Fibrillation: A Quality Improvement Project Session Title: Poster Session PM
Conclusions: Using established quality improvement methodology and cost-neutral multi-disciplinary expertise, this novel management algorithm has significantly improved the quality and safety of care for patients with acute AF at NMUH. Prospective analysis of long-term adverse outcomes is now required to establish morbidity or mortality benefit.
Source: Circulation: Cardiovascular Quality and Outcomes - April 5, 2018 Category: Cardiology Authors: Maclean, E., Patel, S., Joseph, O., de Block Golding, D., Maden, S., Boot, J., Denning, M., Rear, R. Tags: Session Title: Poster Session PM Source Type: research

Abstract 4: Variation in Published Stroke Rates Results in Wide Variation in the Net Clinical Benefit of Anticoagulation for Atrial Fibrillation Session Title: QCOR 2018 Young Investigator Award Finalists
Conclusion: Using current guidelines, variation in published off-anticoagulation stroke rates results in tenfold variation in the estimated net clinical benefit of anticoagulation. Guidelines should better reflect the uncertainty of the current approach that uses a CHA2DS2-VASc threshold to recommend anticoagulation.
Source: Circulation: Cardiovascular Quality and Outcomes - April 5, 2018 Category: Cardiology Authors: Shah, S. J., Eckman, M. H., Aspberg, S., Go, A. S., Singer, D. E. Tags: Session Title: QCOR 2018 Young Investigator Award Finalists Source Type: research

Abstract 14: The Influence of Provider Specialty on Anticoagulation Prescription Fills and Stroke Risk in Atrial Fibrillation Patients With History of Cancer Session Title: Poster Session Reception: Young Investigator Award Semi-Finalists
Conclusion: AF patients with cancer were less likely to see a cardiologist, and less likely to fill an anticoagulant prescription than AF patients without cancer. However, cardiology involvement was associated with increased anticoagulant prescription fills and reduced risk of stroke, suggesting a beneficial role for cardiology providers to improve outcomes in AF patients with history of cancer.
Source: Circulation: Cardiovascular Quality and Outcomes - April 5, 2018 Category: Cardiology Authors: ONeal, W. T., Claxton, J., MacLehose, R., Chen, L., Bengtson, L. G., Chamberlain, A. M., Norby, F., Lutsey, P., Alonso, A. Tags: Session Title: Poster Session Reception: Young Investigator Award Semi-Finalists Source Type: research

Abstract 107: Differential Ischemic Stroke Risk Among Women Veterans Across Age Strata Session Title: Poster Session AM
Conclusions: Nearly half of all women Veterans were found to be at high risk of ischemic stroke within the next 10-years. Furthermore, sex differences were noted across age strata, with women having a lower risk of stroke then men at younger ages and a higher risk at older ages. Given that women tend to have more severe strokes, higher mortality, and delayed diagnosis compared to men, further work is required to understand reasons for the differential stroke risk across sexes. Based on these study findings, implementing primary prevention programs for women Veterans would help to mitigate future ischemic stroke risk.
Source: Circulation: Cardiovascular Quality and Outcomes - April 5, 2018 Category: Cardiology Authors: Comer, A. R., Sico, J., Haggstrom, D. Tags: Session Title: Poster Session AM Source Type: research

Abstract 109: Neurologists versus Hospitalists: The Effect of Physician Specialty on Stroke Care and Outcomes After Ischemic Stroke and TIA Session Title: Poster Session AM
Conclusions: There is no evidence that patients received dissimilar stroke related care or experienced different outcomes regardless of the physician specialty serving as the primary service. However, stroke patients with hospitalists as their primary team had shorter hospital stay. This difference may be due to hospitalists’ expertise in managing patients with multiple co-morbidities, including stroke patients with underlying diabetes, atrial fibrillation, and hypertension. Based on these findings, utilizing neurology as a consult service for stroke related care will not affect provision of stroke care or patient outcomes.
Source: Circulation: Cardiovascular Quality and Outcomes - April 5, 2018 Category: Cardiology Authors: Comer, A. R., Comer, A. D., Dethoff, A., Templeton, E. J., Slaven, J. J. Tags: Session Title: Poster Session AM Source Type: research

Abstract 175: Atrial Fibrillation in the USF Resident Clinics: Quality-Driven Medical Therapy Session Title: Poster Session AM
Patients with atrial fibrillation (afib) have a high rate of serious complications including stroke and decompensated heart failure. While patients with afib are five times more likely to suffer a stroke in their lifetime than the general population, this risk can be reduced by 64% with appropriate anticoagulation using warfarin or approved novel oral anticoagulants (NOACs). Reducing the morbidity and mortality from excess strokes is a common interest nationwide due to unsustainable healthcare costs, increasing human resource gaps in medicine, and payment reforms that hold physicians and healthcare organizations financiall...
Source: Circulation: Cardiovascular Quality and Outcomes - April 5, 2018 Category: Cardiology Authors: Sadic, E. Tags: Session Title: Poster Session AM 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

Anticoagulation for Nonvalvular Atrial Fibrillation: Influence of Epidemiologic Trends and Clinical Practice Patterns on Risk Stratification and Net Clinical Benefit Cardiovascular Perspective
Source: Circulation: Cardiovascular Quality and Outcomes - September 11, 2017 Category: Cardiology Authors: Asinger, R. W., Shroff, G. R., Simegn, M. A., Herzog, C. A. Tags: Arrhythmias, Cerebrovascular Disease/Stroke, Ischemic Stroke Cardiovascular Perspective Source Type: research

Contemporary Trends in Oral Anticoagulant Prescription in Atrial Fibrillation Patients at Low to Moderate Risk of Stroke After Guideline-Recommended Change in Use of the CHADS2 to the CHA2DS2-VASc Score for Thromboembolic Risk Assessment: Analysis From the National Cardiovascular Data Registrys Outpatient Practice Innovation and Clinical Excellence Atrial Fibrillation Registry Original Articles
Conclusions— Adoption of the CHA2DS2-VASc score reclassifies 64.5% of patients with AF with low CHADS2 scores into a class I indication for OAC prescription. Overall OAC prescription increased between 2011 and 2014.
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2017 Category: Cardiology Authors: Katz, D. F., Maddox, T. M., Turakhia, M., Gehi, A., OBrien, E. C., Lubitz, S. A., Turchin, A., Doros, G., Lei, L., Varosy, P., Marzec, L., Hsu, J. C. Tags: Arrhythmias, Anticoagulants, Quality and Outcomes Original Articles Source Type: research

Riskier Business: Atrial Fibrillation Stroke Prevention in the CHA2DS2-VASc Era Editorials
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2017 Category: Cardiology Authors: Dewland, T. A., Stecker, E. C. Tags: Arrhythmias, Quality and Outcomes, Ischemic Stroke Editorials Source Type: research

Noncentral Nervous System Systemic Embolism in Patients With Atrial Fibrillation: Results From ROCKET AF (Rivaroxaban Once Daily, Oral, Direct Factor Xa Inhibition Compared With Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation) Data Report
Source: Circulation: Cardiovascular Quality and Outcomes - May 11, 2017 Category: Cardiology Authors: Orgel, R., Wojdyla, D., Huberman, D., Halperin, J. L., Breithardt, G., Singer, D. E., Fox, K. A. A., Hankey, G. J., Mahaffey, K. W., Jones, W. S., Patel, M. R. Tags: Arrhythmias, Embolism Data Report Source Type: research

Sex-Specific Comparative Effectiveness of Oral Anticoagulants in Elderly Patients With Newly Diagnosed Atrial Fibrillation Original Articles
Conclusions— The reduced risk of ischemic stroke in patients taking rivaroxaban, compared with dabigatran and warfarin, seems to be limited to men, whereas the higher risk of bleeding seems to be limited to women.
Source: Circulation: Cardiovascular Quality and Outcomes - April 13, 2017 Category: Cardiology Authors: Palamaner Subash Shantha, G., Bhave, P. D., Girotra, S., Hodgson-Zingman, D., Mazur, A., Giudici, M., Chrischilles, E., Vaughan Sarrazin, M. S. Tags: Anticoagulants, Cerebrovascular Disease/Stroke Original Articles Source Type: research

Abstract 009: The Impact of Participation in a Telestroke Network on In-hospital Mortality in Georgia Session Title: Abstract Oral Session: General
Conclusions: Acute ischemic stroke patients admitted in hospitals participating in a telestroke program had a more pronounced reduction in in-hospital mortality. However, telestroke coverage did not alter the effect of nighttime admission on in-hospital mortality.
Source: Circulation: Cardiovascular Quality and Outcomes - March 31, 2017 Category: Cardiology Authors: Zhang, D., Ido, M. S., Shi, L., Green, D. Tags: Session Title: Abstract Oral Session: General Source Type: research

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