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Real-World Persistence and Time to Next Treatment With Ibrutinib in Patients With Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma Including Patients at High Risk for Atrial Fibrillation or Stroke
CONCLUSION: This study highlights that elevated baseline AF/stroke-related risk does not adversely impact TTD and TTNT outcomes associated with ibrutinib use. Additionally, TTNT was significantly longer for patients treated with ibrutinib vs. other regimens.PMID:35973891 | DOI:10.1016/j.clml.2022.07.004
Source: Clinical Lymphoma and Myeloma - August 16, 2022 Category: Cancer & Oncology Authors: Anna Narezkina Nausheen Akhter Xiaoxiao Lu Bruno Emond Sumeet Panjabi Shaun P Forbes Annalise Hilts Stephanie Liu Marie-H élène Lafeuille Patrick Lefebvre Qing Huang Michael Choi Source Type: research

Prediction of incident atrial fibrillation in community-based electronic health records: a systematic review with meta-analysis
Conclusions Models externally validated for prediction of incident AF in community-based EHR demonstrate moderate predictive ability and high risk of bias. Novel methods may provide stronger discriminative performance. Systematic review registration PROSPERO CRD42021245093.
Source: Heart - June 10, 2022 Category: Cardiology Authors: Nadarajah, R., Alsaeed, E., Hurdus, B., Aktaa, S., Hogg, D., Bates, M. G. D., Cowan, C., Wu, J., Gale, C. P. Tags: Open access Arrhythmias and sudden death Source Type: research

Safety and effectiveness of appropriately and inappropriately dosed rivaroxaban or apixaban versus warfarin in patients with atrial fibrillation: a cohort study with nested case-control analyses from UK primary care
Conclusions Dosing appropriateness in NVAF was not associated with a significant difference in IS/SE risk or increase in ICB risk versus warfarin. These findings may reflect residual confounding and biases that were difficult to control, as also seen in other observational studies. They should, therefore, be interpreted with caution, and prescribers should adhere to the dosing instructions in the respective Summary of Product Characteristics. Further studies on this topic from real-world populations are needed.
Source: BMJ Open - June 2, 2022 Category: General Medicine Authors: Gonzalez-Perez, A., Roberts, L., Vora, P., Saez, M. E., Brobert, G., Fatoba, S., Garcia Rodriguez, L. A. Tags: Open access, Cardiovascular medicine Source Type: research

Evaluation of antithrombotic use and COVID-19 outcomes in a nationwide atrial fibrillation cohort
Conclusions Pre-existing AT use may be associated with lower odds of COVID-19 death and, while not evidence of causality, provides further incentive to improve AT coverage for eligible individuals with AF.
Source: Heart - May 25, 2022 Category: Cardiology Authors: Handy, A., Banerjee, A., Wood, A. M., Dale, C., Sudlow, C. L. M., Tomlinson, C., Bean, D., Thygesen, J. H., Mizani, M. A., Katsoulis, M., Takhar, R., Hollings, S., Denaxas, S., Walker, V., Dobson, R., Sofat, R., on behalf of the CVD-COVID-UK Consortium Tags: Open access, COVID-19 Cardiac risk factors and prevention Source Type: research

Relationship of diabetes, heart failure, and N ‐terminal pro‐B‐type natriuretic peptide with cardiovascular outcomes in patients with atrial fibrillation
ConclusionsDiabetes and HF were independently associated with an increased risk of CV death/HHF in an unselected AF patient population, and NT-proBNP improved risk assessment. These findings suggest that AF patients with diabetes and/or HF should be managed not only for their risk of stroke and systemic embolic events but also for CV death/HHF.
Source: ESC Heart Failure - May 20, 2022 Category: Cardiology Authors: Felix Hofer, Ulrike Pailer, Patrick Sulzgruber, Christian Gerges, Max ‐Paul Winter, Robert P. Giugliano, Michael Gottsauner‐Wolf, Martin Hülsmann, Niema Kazem, Lorenz Koller, Robert Schönbauer, Alexander Niessner, Christian Hengstenberg, Tags: Original Article Source Type: research

EP News: Clinical
Singer et  al (JAMA Cardiol 2021;6:1364, PMID 34586356) evaluated the temporal association between episodes of atrial fibrillation (AF) and stroke in patients with cardiac implantable electronic devices (CIEDs). In a case-crossover study, data from an electronic health record database were linked with record s of patients with CIEDs. The prespecified duration of AF was ≥5.5 hours during days 1–30 vs days 91–120 prestroke. The main outcome was odds ratio (OR) for stroke comparing AF during days 1–30 vs days 91–120 prestroke.
Source: Heart Rhythm - February 2, 2022 Category: Cardiology Authors: N.A. Mark Estes Tags: EP NEWS Source Type: research

Predicting patient-level new-onset atrial fibrillation from population-based nationwide electronic health records: protocol of FIND-AF for developing a precision medicine prediction model using artificial intelligence
Introduction Atrial fibrillation (AF) is a major cardiovascular health problem: it is common, chronic and incurs substantial healthcare expenditure because of stroke. Oral anticoagulation reduces the risk of thromboembolic stroke in those at higher risk; but for a number of patients, stroke is the first manifestation of undetected AF. There is a rationale for the early diagnosis of AF, before the first complication occurs, but population-based screening is not recommended. Previous prediction models have been limited by their data sources and methodologies. An accurate model that uses existing routinely collected data is n...
Source: BMJ Open - November 2, 2021 Category: General Medicine Authors: Nadarajah, R., Wu, J., Frangi, A. F., Hogg, D., Cowan, C., Gale, C. Tags: Open access, Cardiovascular medicine Source Type: research

Application of Machine Learning Techniques to Identify Data Reliability and Factors Affecting Outcome After Stroke Using Electronic Administrative Records
Conclusion: Electronic administrative records from this cohort produced reliable outcome prediction and identified clinically appropriate factors negatively impacting most outcome variables following hospital admission with stroke. This presents a means of future identification of modifiable factors associated with patient discharge destination. This may potentially aid in patient selection for certain interventions and aid in better patient and clinician education regarding expected discharge outcomes.
Source: Frontiers in Neurology - September 27, 2021 Category: Neurology Source Type: research

P-043 Elevated D-dimer levels predicts mortality in COVID-19 with stroke: analysis of multi-center electronic health record data
ConclusionsPeak D-dimer levels above 5.15 µg/ml feu are associated with increased mortality in COVID-19 patients with AIS.Disclosures Y. Kim: None. S. Khose: None. R. Abdelkhaleq: None. S. Salazar-Marioni: None. S. Sheth: None.
Source: Journal of NeuroInterventional Surgery - July 26, 2021 Category: Neurosurgery Authors: Kim, Y., Khose, S., Abdelkhaleq, R., Salazar-Marioni, S., Sheth, S. Tags: Oral poster abstracts Source Type: research

Appropriateness of inpatient dosing of direct oral anticoagulants for atrial fibrillation
The objective was to determine the rates of inappropriate inpatient DOAC dosing in AF and identifying its associated underlying factors. We conducted a retrospective cross-sectional study from December 2013 to November 2019 across six South Australian public hospitals utilising a centralised electronic health record. Multivariate analysis was used to identify factors associated with underdosing of patients prescribed apixaban. Of 1882 inpatients, 544 (28.9  %) were inappropriately dosed. Underdosing was the most common form of inappropriate dosing with rates of 22.9 % (n = 295), 7.1 % (n = 7), and 25.1 % (n...
Source: Journal of Thrombosis and Thrombolysis - July 24, 2021 Category: Hematology Source Type: research

SUPPORT ‐AF III: supporting use of AC through provider prompting about oral anticoagulation therapy for AF
AbstractOnly half of atrial fibrillation (AF) patients with elevated stroke risk receive anticoagulation (AC). Electronic health record (EHR) alerts have the potential to close the gap. We designed an outpatient EHR alert (linked to an order set for ordering AC, labs, and specialty referrals) that fired when cardiology and primary care providers (PCPs) saw AF patients not on AC. We assigned all untreated patients seen by cardiology providers and PCPs in the 8  months before and after the alert launch to pre- and post-launch intervention cohorts, respectively. Untreated AF patients seeing other types of providers became co...
Source: Journal of Thrombosis and Thrombolysis - March 10, 2021 Category: Hematology Source Type: research

IJERPH, Vol. 18, Pages 2244: Oral Anticoagulant Adequacy in Non-Valvular Atrial Fibrillation in Primary Care: A Cross-Sectional Study Using Real-World Data (Fantas-TIC Study)
Conclusions: Poor adequacy to current criteria was observed, being inadequacy higher in DOACs than in VKAs. TTR and GFR should be routinely calculated in electronic health records (EHR) to facilitate decision-making and patient safety.
Source: International Journal of Environmental Research and Public Health - February 24, 2021 Category: Environmental Health Authors: Dalmau Llorca Aguilar Mart ín Carrasco-Querol Hern ández Rojas Forcadell Drago Cumplido Pepi ó Vilaubí Castro Blanco Gon çalves Fern ández-Sáez Tags: Article Source Type: research

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