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Abstract 223: Impact of Differences in Once- vs Twice-Daily Medications Adherence on the Risk of Bleed and Stroke in Non-Valvular Atrial Fibrillation: Analysis of Randomized Trials and Claims Data Sources Session Title: Poster Session II
Conclusion: Among NVAF patients, better adherence to QD dosing was associated with a significantly lower stroke risk of QD but similar risk of bleed.
Source: Circulation: Cardiovascular Quality and Outcomes - March 31, 2017 Category: Cardiology Authors: McHorney, C. A., Peterson, E. D., Durkin, M., Ashton, V., Laliberte, F., Crivera, C., Sheikh, N., Germain, G., Schein, J. R., Xiao, Y., Lefebvre, P. Tags: Session Title: Poster Session II Source Type: research

Abstract 072: Impact of Chronic Diabetes on Periprocedural Outcomes Among Patient With Atrial Fibrillation and Flutter Who Underwent Radiofrequency Catheter Ablation Therapy (RFA). Report From the NIS 2014. Session Title: Poster Session I
Conclusions: RFA has a similar procedural safety in diabetics when compared to non-diabetic patients. It remains a safe procedure in diabetics with drug-refractory atrial fibrillation and flutter. Renal failure, CHF, type of Insurance, hospital location and teaching status are predictors of complications after RFA.
Source: Circulation: Cardiovascular Quality and Outcomes - March 31, 2017 Category: Cardiology Authors: Alliu, S. E., Adejumo, A., Durojaiye, M., Emmanuel, A., Wolf, L., Lichstein, E., Hecht, M., Stephan, K., Adegbala, O., Onyeakusi, N., Ajayi, T. Tags: Session Title: Poster Session I Source Type: research

Abstract 116: Relationship of Stroke Unit Status With Quality of Care and Outcome for Acute Stroke Patients: Results From China National Stroke Registry II Session Title: Poster Session I
Conclusions: Our study showed that processes of care of AIS were better in patients in hospitals with stroke units. However, patients in hospitals with stroke units didn’t performance differences in clinical outcomes after discharge.
Source: Circulation: Cardiovascular Quality and Outcomes - March 31, 2017 Category: Cardiology Authors: Zhang, X., Li, Z., Wang, C., Wang, C., Yang, X., Gu, H., Pan, Y., Liu, L., Zhao, X., Wang, Y., Wang, Y. 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 126: The Association Between Medication Aherence and Time in Therapeutic Range (TTR) Among Patients with Atrial Fibrillation Treated With Warfarin: Lessons From the Parkland Health and Hospital System Session Title: Poster Session I
Conclusions: TTR to Warfarin in this underserved population is suboptimal. Given that adherence to Warfarin is independently associated with poor TTR, in the absence of strong adherence interventions, a policy of universal NOAC adoption is unlikely to significantly improve outcomes. If patients are transitioned to NOACs, this data implies that a targeted adherence intervention will be necessary to ensure that the medication is effective in reducing the risk of stroke.
Source: Circulation: Cardiovascular Quality and Outcomes - March 31, 2017 Category: Cardiology Authors: Wang, J., Vigen, R., Clark, C., Das, S. Tags: Session Title: Poster Session I Source Type: research

Abstract 127: Differences in Care Patterns, Health Status, and Outcomes of Atrial Fibrillation in Patients With and Without Diabetes: Findings From the ORBIT-AF Registry Session Title: Poster Session I
Conclusions: Among patients with AF, diabetes was associated with worse AF symptoms and lower quality of life, as well an increased risk of death and hospitalizations, but not with the risk of thromboembolic or bleeding events.
Source: Circulation: Cardiovascular Quality and Outcomes - March 31, 2017 Category: Cardiology Authors: Echouffo Tcheugui, J. B., Shrader, P., Thomas, L., Gersh, B. J., Kowey, P., Mahaffey, K. W., Singer, D. E., Hylek, E. M., Go, A. S., Peterson, E. D., Piccini, J. P., Fonarow, G. C. F. C. Tags: Session Title: Poster Session I Source Type: research

Abstract 155: Prevalence and Clinical Correlates of Left Ventricular Hypertrophy by Sokolow-Lyon and Cornell Electrocardiogram Voltage Criteria in Transcatheter Aortic Valve Replacement Patients Session Title: Poster Session II
Conclusion: The presence of LVH by Sokolow-Lyon and Cornell ECG voltage criteria poorly correlates with the presence of LVH and critical aortic stenosis in TAVR patients. Women are more likely to have voltage criteria for LVH. Therefore, ECG may not be a suitable method of screening patients with severe aortic stenosis for LVH, especially in men.
Source: Circulation: Cardiovascular Quality and Outcomes - March 31, 2017 Category: Cardiology Authors: Xiao, E., Delago, A., El-Hajjar, M., Bulibek, B., Torosoff, M. Tags: Session Title: Poster Session II 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

Atrial Fibrillation Diagnosis Timing, Ambulatory ECG Monitoring Utilization, and Risk of Recurrent Stroke Original Articles
Conclusions— AF diagnosed after stroke is an important hallmark of recurrent stroke risk. Increasing the low utilization of cardiac monitoring after stroke could identify undiagnosed AF earlier, leading to appropriate oral anticoagulation treatment and a reduction in stroke/TIA recurrence.
Source: Circulation: Cardiovascular Quality and Outcomes - January 16, 2017 Category: Cardiology Authors: Lip, G. Y. H., Hunter, T. D., Quiroz, M. E., Ziegler, P. D., Turakhia, M. P. Tags: Arrhythmias, Electrophysiology, Atrial Fibrillation, Ischemic Stroke, Transient Ischemic Attack (TIA) 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

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

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

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

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