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Blood Pressure, Antihypertensive Polypharmacy, Frailty, and Risk for Serious Fall Injuries Among Older Treated Adults With HypertensionNovelty and Significance Epidemiology/Population
In conclusion, indicators of frailty, but not BP or number of antihypertensive medication classes, were associated with increased risk for serious fall injuries among older adults taking antihypertensive medication.
Source: Hypertension - July 12, 2017 Category: Cardiology Authors: Samantha G. Bromfield, Cedric-Anthony Ngameni, Lisandro D. Colantonio, C. Barrett Bowling, Daichi Shimbo, Kristi Reynolds, Monika M. Safford, Maciej Banach, Peter P. Toth, Paul Muntner Tags: Hypertension Original Articles Source Type: research

Impact of Ezetimibe on the Rate of Cardiovascular-Related Hospitalizations and Associated Costs Among Patients With a Recent Acute Coronary Syndrome: Results From the IMPROVE-IT Trial (Improved Reduction of Outcomes: Vytorin Efficacy International Trial) Original Articles
Conclusions— Addition of ezetimibe to statin therapy in patients with a recent acute coronary syndrome leads to reductions in cardiovascular-related hospitalizations and associated costs, with the greatest cost offsets in high-risk patients. These cost reductions may completely offset the cost of the drug once ezetimibe becomes generic, and may lead to cost savings from the perspective of the healthcare system, if treatment with ezetimibe is targeted to high-risk patients. Clinical Trial Registration— URL: https://www.clinicaltrials.gov. Unique Identifier: NCT00202878
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2017 Category: Cardiology Authors: Pokharel, Y., Chinnakondepalli, K., Vilain, K., Wang, K., Mark, D. B., Davies, G., Blazing, M. A., Giugliano, R. P., Braunwald, E., Cannon, C. P., Cohen, D. J., Magnuson, E. A. Tags: Secondary Prevention, Cost-Effectiveness, Health Services Original Articles Source Type: research

The Role for Cardiologists in Stroke Intervention
Even though cardiovascular disease (CVD) is still the leading cause of death in the United States, stroke is the second leading of global cause of death behind CVD . In the 21st Century, less than 40% of overall stroke patients are discharged to home and almost 25% of Medicare beneficiaries do not survive 90days. In spite of the fact that tissue plasminogen activator (TPA) has been approved for stroke care for 20years, only .75% of annual strokes are actually treated with intravenous (IV) TPA. Similar to how interventional cardiologists evolved from IV to catheter mechanical treatment for acute myocardial infarctions (AMI)...
Source: Progress in Cardiovascular Diseases - May 11, 2017 Category: Cardiology Authors: Richard R. Heuser Source Type: research

Cardiovascular events and hospital resource utilization pre – and post–transcatheter mitral valve repair in high–surgical risk patients
Conclusions MitraClip was associated with a reduced rate of all-cause and HF hospitalizations and an increased rate of bleeding hospitalizations. One-year Medicare costs were reduced in those who survived a full year after the MitraClip procedure. Payors and providers seeking to reduce HF hospitalizations and associated Medicare costs may consider MitraClip among appropriate patients likely to survive 1 year.
Source: American Heart Journal - May 10, 2017 Category: Cardiology Source Type: research

Peripheral Artery Disease Prevalence and Incidence Estimated From Both Outpatient and Inpatient Settings Among Medicare Fee-for-Service Beneficiaries in the Atherosclerosis Risk in Communities (ARIC) Study Epidemiology
ConclusionsThis study provides comprehensive estimates of PAD in the inpatient and outpatient settings where the majority of PAD burden was found. PAD is an important circulatory system disorder similar in prevalence to stroke and coronary heart disease.
Source: JAHA:Journal of the American Heart Association - May 3, 2017 Category: Cardiology Authors: Kalbaugh, C. A., Kucharska-Newton, A., Wruck, L., Lund, J. L., Selvin, E., Matsushita, K., Bengtson, L. G. S., Heiss, G., Loehr, L. Tags: Epidemiology, Peripheral Vascular Disease Original Research Source Type: research

Who Should Be Referred for Left Atrial Appendage Occlusion Therapy?
Opinion statementAtrial fibrillation (AF) is the most common cardiac arrhythmia affecting approximately 7 million individuals in USA. It is one of the most significant arrhythmias, which accounts for a majority of embolic strokes, especially in elderly individuals. Although oral anti-coagulation is beneficial in lowering the risk of stroke, 1 in 10 patients have a contra-indication to warfarin therapy. Among patients who do tolerate either warfarin or novel oral anticoagulant (NOAC), major or recurrent bleeding, intracranial bleeds, etc. often lead to interruption of anti-coagulation. Previous studies have reported that>...
Source: Current Treatment Options in Cardiovascular Medicine - May 2, 2017 Category: Cardiology 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 200: Is Risk-standardized In-hospital Stroke Mortality an Adequate Proxy for Risk-standardized 30-day Stroke Mortality Data? Findings From the GWTG-Stroke Program Session Title: Poster Session II
Conclusions: When used to identify outlier hospitals with high or low ischemic stroke mortality the agreement between in-hospital mortality and 30-day mortality was only modest. Using in-hospital mortality data proved to be a poor proxy for 30-day mortality.
Source: Circulation: Cardiovascular Quality and Outcomes - March 31, 2017 Category: Cardiology Authors: Reeves, M. J., Fonarow, G. C., Xu, H., Matsouaka, R., Xian, Y., Saver, J., Schwamm, L. H., Smith, E. E. Tags: Session Title: Poster Session II Source Type: research

Abstract 043: Health Insurance and the Risk of Incident Cardiovascular Disease in the Multi-Ethnic Study of Atherosclerosis Session Title: Poster Session I
Conclusions: The association of health insurance with CVD incidence varied by insurance group, and private insurance was associated with a lower risk of incident CVD. Further exploration of the features of health insurance coverage that impact CVD incidence may facilitate improvements in the primary prevention of CVD.
Source: Circulation: Cardiovascular Quality and Outcomes - March 31, 2017 Category: Cardiology Authors: Crim, M. T., Xie, J. X., Ko, Y.-A., Blumenthal, R. S., Blaha, M. J., Nasir, K., Budoff, M. J., Shaw, L. J. Tags: Session Title: Poster Session I Source Type: research

Abstract 054: Mortality Decline After Ischemic Stroke-the Medicare Cohort From 2009 to 2013 Session Title: Poster Session I
Conclusion: The one-year mortality among Medicare beneficiaries after ischemic stroke hospitalization showed a dramatic decline from 2009 to 2013. Further study is needed to determine whether this is attributable to the change of stroke system of care in the past decade.
Source: Circulation: Cardiovascular Quality and Outcomes - March 31, 2017 Category: Cardiology Authors: Man, S., Schold, J. D., Uchino, K. Tags: Session Title: Poster Session I 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 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

Cardiovascular Health and Healthcare Utilization and Expenditures Among Medicare Beneficiaries: The REasons for Geographic And Racial Differences in Stroke (REGARDS) Study Health Services and Outcomes Research
ConclusionsBetter cardiovascular health is associated with lower risk for inpatient encounters and lower inpatient and outpatient healthcare expenditures.
Source: JAHA:Journal of the American Heart Association - February 1, 2017 Category: Cardiology Authors: Aaron, K. J., Colantonio, L. D., Deng, L., Judd, S. E., Locher, J. L., Safford, M. M., Cushman, M., Kilgore, M. L., Becker, D. J., Muntner, P. Tags: Cardiovascular Disease, Risk Factors, Cost-Effectiveness, Health Services, Statements and Guidelines Original Research Source Type: research

National Patterns in Intensity and Frequency of Outpatient Care for Apparent Treatment-Resistant Hypertension
In conclusion, many people with UaTRH are not seen more than once per year for hypertension and may benefit from increased care.
Source: American Heart Journal - January 20, 2017 Category: Cardiology Source Type: research

Comparing Stroke and Bleeding with Rivaroxaban and Dabigatran in Atrial Fibrillation: Analysis of the US Medicare Part D Data
ConclusionsThere was no difference in stroke prevention between rivaroxaban and dabigatran; however, rivaroxaban was associated with a higher risk of thromboembolic events other than stroke, death, and bleeding.
Source: American Journal of Cardiovascular Drugs - September 13, 2016 Category: Cardiology Source Type: research

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