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Abstract 2: Comparative Effectiveness and Safety of Anticoagulant Therapy With Warfarin, Dabigatran, Apixaban, or Rivaroxaban in Patients With Nonvalvular Atrial Fibrillation Session Title: Abstract Oral Session: QCOR 2016 Young Investigator Awards
Conclusions: Our results demonstrated a lower risk of a thromboembolic event or stroke among dabigatran, apixaban, or rivaroxaban users compared to warfarin users. Among NOACs, risks of a thromboembolic event or stroke were similar. Further studies are needed to clarify the finding of a higher major bleeding risk in warfarin and rivaroxaban users.
Source: Circulation: Cardiovascular Quality and Outcomes - February 26, 2016 Category: Cardiology Authors: Adeboyeje, G., Sylwestrzak, G., White, J., Rosenberg, A., Abarca, J., Crawford, G., Barron, J. Tags: Session Title: Abstract Oral Session: QCOR 2016 Young Investigator Awards Source Type: research

Abstract 10: Pre-stroke Antithrombotic Therapy and Stroke Severity in Acute Ischemic Stroke Patients with Atrial Fibrillation Session Title: Abstract Oral Session: Outcomes
Conclusions: A majority of AF patients presenting with AIS are not on guideline recommended anticoagulation or are not therapeutic on their anticoagulation. Even when strokes occurred on therapeutic warfarin or a NOAC, the strokes were less severe. These findings highlight the huge opportunities to further improve proper use of oral anticoagulants in eligible AF patients.
Source: Circulation: Cardiovascular Quality and Outcomes - February 26, 2016 Category: Cardiology Authors: Xian, Y., OBrien, E. C., Liang, L., Pencina, M. J., Schwamm, L. H., Fonarow, G. C., Bhatt, D. L., Smith, E. E., Maisch, L., Hannah, D., Lindholm, B., Lytle, B. L., Hernandez, A. F., Peterson, E. D. Tags: Session Title: Abstract Oral Session: Outcomes Source Type: research

Abstract 22: Impact of CHA2DS2-VASc Risk Factors on Anticoagulant Prescription in Patients with Atrial Fibrillation: Insights From the NCDR(R) PINNACLE Registry Session Title: Abstract Oral Session
Conclusions: Among this cohort of AF patients with an indication for OAC use, older age and HTN were strongly associated with greater OAC use whereas female gender and vascular disease were associated with less OAC use. Further investigation is needed to understand reasons for these differences in how risk factors influence decisions to provide OAC, such as patient or provider preference or gender bias.
Source: Circulation: Cardiovascular Quality and Outcomes - February 26, 2016 Category: Cardiology Authors: Thompson, L. E., Maddox, T. M., Lei, L., Grunwald, G. K., Bradley, S. M., Peterson, P. N., Daugherty, S. L., Masoudi, F. A. Tags: Session Title: Abstract Oral Session Source Type: research

Abstract 138: Contemporary Patterns of Use of Antiplatelet Agents in Patients With Acute Myocardial Infarction: Insight From the National Cardiovascular Data Registry (NCDR) Session Title: Abstract Poster Session I and Reception
Conclusions: Our contemporary dataset shows a modest but significant increase in use of ticagrelor early and at discharge, with simultaneous decline in the use of clopidogrel and prasugrel in patients presenting with AMI.
Source: Circulation: Cardiovascular Quality and Outcomes - February 26, 2016 Category: Cardiology Authors: Basra, S. S., Wang, T. Y., Simon, D. N., Chiswell, K., Virani, S. S., Alam, M., Nambi, V., Denktas, A. E., Deswal, A., Ballantyne, C. M., Peterson, E. D., Jneid, H. M. Tags: Session Title: Abstract Poster Session I and Reception Source Type: research

Abstract 149: Effects of Ethnicity and Prior Depression on Hospital Course and Outcomes in First-Time Stroke Patients Session Title: Abstract Poster Session I and Reception
Conclusions: There was a combined effect of ethnicity and depression on LOS where non-Hispanic patients with depression had a shorter LOS than other groups. Although not statistically significant, the findings may be clinically important. It is critical to determine whether these patients had less severe strokes or fewer comorbidities, or if patients were discharged too quickly.
Source: Circulation: Cardiovascular Quality and Outcomes - February 26, 2016 Category: Cardiology Authors: Starosciak, A. K., Payret, K., Ramirez, M., Viera, Y., Alegria, C., Bedgio, R., Ruiz, F. Tags: Session Title: Abstract Poster Session I and Reception Source Type: research

Abstract 154: Estimating Treatment Effects in More Than Two Treatment Groups via Propensity Score Weighting: Practical Guidance and Application from Anticoagulant Therapy in Atrial Fibrillation Study Session Title: Abstract Poster Session I and Reception
Conclusions: Our results showed IPTW methods, correctly employed under certain assumptions, are practical and relatively simple tools to control for selection bias and other baseline differences in observational studies evaluating the comparative treatment effects of more than two treatment arms. When preserving sample size is important and in the presence of time-varying confounders, IPTW methods have distinct advantages over propensity matching or adjustment.
Source: Circulation: Cardiovascular Quality and Outcomes - February 26, 2016 Category: Cardiology Authors: Adeboyeje, G., Sylwestrzak, G., Barron, J. Tags: Session Title: Abstract Poster Session I and Reception 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

Abstract 203: Preventing Stroke in Patients With Atrial Fibrillation: A Review of Published Interventions to Aid Patient Decision Making Session Title: Abstract Poster Session II
Conclusion: Interventions designed to aid patient decision making around stroke prevention in AF improved a selection of patient-centered outcomes. Given the availability of multiple NOACs and an implantable device for stroke prevention in AF, there is a need to develop and evaluate new patient decision support tools.
Source: Circulation: Cardiovascular Quality and Outcomes - February 26, 2016 Category: Cardiology Authors: ONeill, E. S., Grande, S. W., Elwyn, G., Coylewright, M. Tags: Session Title: Abstract Poster Session II Source Type: research

Abstract 204: Echocardiographic Evidence for Systemic Atherosclerosis, Atrial Fibrillation, and Long-Term Prognosis in Stroke Patients Session Title: Abstract Poster Session II
Conclusion: In patients with non-hemorrhagic stroke, cardiac and systemic evidence of atherosclerosis was strongly associated with atrial fibrillation and portended poor long-term prognosis. In stroke patients with cardiac and systemic evidence of atherosclerosis and rhythms other than atrial fibrillation, extended ECG monitoring may be warranted.
Source: Circulation: Cardiovascular Quality and Outcomes - February 26, 2016 Category: Cardiology Authors: Pieper, J., Ashamalla, M., Yager, N., Sedhom, D., Gate, K., Nguyen, V., Shkolnik, B., Torosoff, M. Tags: Session Title: Abstract Poster Session II Source Type: research

Sex Differences in Dabigatran Use, Safety, And Effectiveness In a Population-Based Cohort of Patients With Atrial Fibrillation Original Articles
Conclusions— In real-life practice, women are more frequently treated with low-dose dabigatran, yet a trend toward lower stroke rates in women taking high-dose dabigatran was observed. Men benefit from lower bleeding rates with dabigatran compared with warfarin.
Source: Circulation: Cardiovascular Quality and Outcomes - November 17, 2015 Category: Cardiology Authors: Avgil Tsadok, M., Jackevicius, C. A., Rahme, E., Humphries, K. H., Pilote, L. Tags: Epidemiology, Anticoagulants, Ethics and Policy Original Articles 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

Quality of Care and Ischemic Stroke Risk After Hospitalization for Transient Ischemic Attack: Findings From Get With The Guidelines-Stroke Original Articles
Conclusions— TIA patients with high estimated ischemic stroke risk are less likely to receive defect-free care than low-risk patients. Standardized risk assessment and delivery of optimal inpatient care are needed to reduce this risk-treatment mismatch.
Source: Circulation: Cardiovascular Quality and Outcomes - October 29, 2015 Category: Cardiology Authors: O'Brien, E. C., Zhao, X., Fonarow, G. C., Schulte, P. J., Dai, D., Smith, E. E., Schwamm, L. H., Bhatt, D. L., Xian, Y., Saver, J. L., Reeves, M. J., Peterson, E. D., Hernandez, A. F. Tags: Ethics and Policy Original Articles Source Type: research

Novel Oral Anticoagulant Use Among Patients With Atrial Fibrillation Hospitalized With Ischemic Stroke or Transient Ischemic Attack Original Articles
Conclusions— NOACs have had modest but growing uptake over time among atrial fibrillation patients hospitalized with stroke or transient ischemic attack and are prescribed to patients with lower stroke risk compared with warfarin.
Source: Circulation: Cardiovascular Quality and Outcomes - July 21, 2015 Category: Cardiology Authors: Patel, P. A., Zhao, X., Fonarow, G. C., Lytle, B. L., Smith, E. E., Xian, Y., Bhatt, D. L., Peterson, E. D., Schwamm, L. H., Hernandez, A. F. Tags: Other anticoagulants, Embolic stroke, Anticoagulants Original Articles Source Type: research

Intracranial Hemorrhage After Ischemic Stroke: Incidence, Time Trends, and Predictors in a Swedish Nationwide Cohort of 196 765 Patients Original Articles
Conclusions— The incidence of ICrH within 1 year after ischemic stroke was 2% per year at risk, about 15 times higher compared with the reference population. Over the study period, ICrH risk increased within the first 30 days but decreased thereafter. Previous ICrH, thrombolysis, and male sex affected the risk, whereas an increased use of antithrombotic treatments and statins did not.
Source: Circulation: Cardiovascular Quality and Outcomes - July 21, 2015 Category: Cardiology Authors: Ogren, J., Irewall, A.-L., Bergstrom, L., Mooe, T. Tags: Acute Cerebral Hemorrhage, Acute Cerebral Infarction, Epidemiology Original Articles Source Type: research

Insulin Resistance and Risk of Cardiovascular Disease in Postmenopausal Women: A Cohort Study From the Women's Health Initiative Original Articles
Conclusions— Measures of insulin resistance were no longer associated with CVD risk after adjustment for high-density lipoprotein-cholesterol and did not provide independent prognostic information in postmenopausal women without diabetes mellitus. Clinical Trial Registration Information— URL: http://www.clinicaltrial.gov. Unique identifier: NCT00000611.
Source: Circulation: Cardiovascular Quality and Outcomes - May 19, 2015 Category: Cardiology Authors: Schmiegelow, M. D., Hedlin, H., Stefanick, M. L., Mackey, R. H., Allison, M., Martin, L. W., Robinson, J. G., Hlatky, M. A. Tags: Health policy and outcome research, Risk Factors, Acute myocardial infarction, Acute Cerebral Infarction, Epidemiology Original Articles Source Type: research

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