6,692 results on '"Peterson, Eric D"'
Search Results
2. Does the Effectiveness of a Medicine Copay Voucher Vary by Baseline Medication Out‐Of‐Pocket Expenses? Insights From ARTEMIS
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Rymer, Jennifer A, Kaltenbach, Lisa A, Peterson, Eric D, Cohen, David J, Fonarow, Gregg C, Choudhry, Niteesh K, Henry, Timothy D, Cannon, Christopher P, and Wang, Tracy Y
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Biomedical and Clinical Sciences ,Clinical Sciences ,Cost Effectiveness Research ,Heart Disease - Coronary Heart Disease ,Cardiovascular ,Heart Disease ,Good Health and Well Being ,Humans ,Health Expenditures ,Medication Adherence ,Myocardial Infarction ,Purinergic P2Y Receptor Antagonists ,Treatment Outcome ,copay ,myocardial infarction ,persistence ,voucher ,Cardiorespiratory Medicine and Haematology ,Cardiovascular medicine and haematology - Abstract
Background Persistence to P2Y12 inhibitors after myocardial infarction (MI) remains low. Out-of-pocket cost is cited as a factor affecting medication compliance. We examined whether a copayment intervention affected 1-year persistence to P2Y12 inhibitors and clinical outcomes. Methods and Results In an analysis of ARTEMIS (Affordability and Real-World Antiplatelet Treatment Effectiveness After Myocardial Infarction Study), patients with MI discharged on a P2Y12 inhibitor were stratified by baseline out-of-pocket medication burden: low ($0-$49 per month), intermediate ($50-$149 per month), and high (≥$150 per month). The impact of the voucher intervention on 1-year P2Y12 inhibitor persistence was examined using a logistic regression model with generalized estimating equations. We assessed the rates of major adverse cardiovascular events among the groups using a Kaplan-Meier estimator. Among 7351 MI-treated patients at 282 hospitals, 54.2% patients were in the low copay group, 32.0% in the middle copay group, and 13.8% in the high copay group. Patients in higher copay groups were more likely to have a history of prior MI, heart failure, and diabetes compared with the low copay group (all P
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- 2022
3. Apolipoprotein B: Bridging the Gap Between Evidence and Clinical Practice
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De Oliveira-Gomes, Diana, Joshi, Parag H., Peterson, Eric D., Rohatgi, Anand, Khera, Amit, and Navar, Ann Marie
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- 2024
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4. Time-dependent event accumulation in a cardiovascular outcome trial of patients with type 2 diabetes and established atherosclerotic cardiovascular disease
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Bethel, M. Angelyn, Sourij, Harald, Stevens, Susanna R., Hannan, Karen, Lokhnygina, Yuliya, Adler, Amanda I., Peterson, Eric D., Holman, Rury R., and Lopes, Renato D.
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- 2023
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5. Identifying a stable and generalizable factor structure of major depressive disorder across three large longitudinal cohorts
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Schilsky, Richard L., Allen, Jennifer, Anderson, MaryAnn, Anstrom, Kevin, Araujo, Lucus, Arges, Kristine, Ardalan, Kaveh, Baldwin, Bridget, Balu, Suresh, Bashir, Mustafa R., Bhapkar, Manju, Bigelow, Robert, Black, Tanya, Blanco, Rosalia, Bloomfield, Gerald, Borkar, Durga, Bouk, Leah, Boulware, Ebony, Brugnoni, Nikki, Campbell, Erin, Campbell, Paul, Carin, Larry, Cassella, Tammy Jo, Cates, Tina, Montgomery, Ranee Chatterjee, Christian, Victoria, Choong, John, Cohen-Wolkowiez, Michael, Cook, Elizabeth, Cousins, Scott, Crawford, Ashley, Datta, Nisha, Daubert, Melissa, Davis, James, Dirkes, Jillian, Doan, Isabelle, Dockery, Marie, Douglas, Pamela S., Duckworth, Shelly, Dunham, Ashley, Dunn, Gary, Ebersohl, Ryan, Eckstrand, Julie, Fang, Vivienne, Flora, April, Ford, Emily, Foster, Lucia, Fraulo, Elizabeth, French, John, Ginsburg, Geoffrey S., Green, Cindy, Greene, Latoya, Guptill, Jeffrey, Hamel, Donna, Hamill, Jennifer, Harrington, Chris, Harrison, Rob, Hedges, Lauren, Heidenfelder, Brooke, Hernandez, Adrian F., Heydary, Cindy, Hicks, Tim, Hight, Lina, Hopkins, Deborah, Huang, Erich S., Huh, Grace, Hurst, Jillian, Inman, Kelly, Janas, Gemini, Jaffee, Glenn, Johnson, Janace, Keaton, Tiffanie, Khouri, Michel, King, Daniel, Korzekwinski, Jennifer, Koweek, Lynne H., Kuo, Anthony, Kwee, Lydia, Landis, Dawn, Lipsky, Rachele, Lopez, Desiree, Lowry, Carolyn, Marcom, Kelly, Marsolo, Keith, McAdams, Paige, McCall, Shannon, McGarrah, Robert, McGugan, John, Mee, Dani, Mervin-Blake, Sabrena, Mettu, Prithu, Meyer, Mathias, Meyers, Justin, Miller, Calire N., Moen, Rebecca, Muhlbaier, Lawrence H., Murphy, Michael, Neely, Ben, Newby, L. Kristin, Nicoldson, Jayne, Nguyen, Hoang, Nguyen, Maggie, O'Brien, Lori, Onal, Sumru, O'Quinn, Jeremey, Page, David, Pagidipati, Neha J., Parikh, Kishan, Palmer, Sarah R., Patrick-Lake, Bray, Pattison, Brenda, Pencina, Michael, Peterson, Eric D., Piccini, Jon, Poole, Terry, Povsic, Tom, Provencher, Alicia, Rabineau, Dawn, Rich, Annette, Rimmer, Susan, Schwartz, Fides, Serafin, Angela, Shah, Nishant, Shah, Svati, Shields, Kelly, Shipes, Steven, Shrader, Peter, Stiber, Jon, Sutton, Lynn, Swamy, Geeta, Thomas, Betsy, Torres, Sandra, Tucci, Debara, Twisdale, Anthony, Walker, Brooke, Whitney, Susan A., Williamson, Robin, Wilverding, Lauren, Wong, Charlene A., Wruck, Lisa, Young, Ellen, Perlmutter, Jane, Krug, Sarah, Bowman-Zatzkin, S. Whitney, Assimes, Themistocles, Bajaj, Vikram, Cheong, Maxwell, Das, Millie, Desai, Manisha, Fan, Alice C., Fleischmann, Dominik, Gambhir, Sanjiv S., Gold, Garry, Haddad, Francois, Hong, David, Langlotz, Curtis, Liao, Yaping J., Lu, Rong, Mahaffey, Kenneth W., Maron, David, McCue, Rebecca, Munshi, Rajan, Rodriguez, Fatima, Shashidhar, Sumana, Sledge, George, Spielman, Susie, Spitler, Ryan, Swope, Sue, Williams, Donna, Pepine, Carl J, Lantos, John D, Pignone, Michael, Heagerty, Patrick, Beskow, Laura, Bernard, Gordon, Abad, Kelley, Angi, Giulia, Califf, Robert M., Deang, Lawrence, Huynh, Joy, Liu, Manway, Mao, Cherry, Magdaleno, Michael, Marks, William J., Jr., Mega, Jessica, Miller, David, Ong, Nicole, Patel, Darshita, Ridaura, Vanessa, Shore, Scarlet, Short, Sarah, Tran, Michelle, Vu, Veronica, Wong, Celeste, Green, Robert C., Hernandez, John, Benge, Jolene, Negrete, Gislia, Sierra, Gelsey, Schaack, Terry, Tseng, Vincent W.S., Tharp, Jordan A., Reiter, Jacob E., Ferrer, Weston, Hong, David S., Doraiswamy, P. Murali, and Nickels, Stefanie
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- 2024
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6. National Variation in Hospital MTEER Outcomes and Correlation With TAVR Outcomes: STS/ACC TVT Registry Analysis
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Kumbhani, Dharam J., Manandhar, Pratik, Bavry, Anthony A., Chhatriwalla, Adnan K., Giri, Jay, Mack, Michael, Carroll, John, Pandey, Ambarish, Kosinski, Andrzej, Peterson, Eric D., Kaneko, Tsuyoshi, de Lemos, James A., and Vemulapalli, Sreekanth
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- 2024
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7. Antithrombotic Therapy for Stroke Prevention in Patients With Ischemic Stroke With Aspirin Treatment Failure
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Lusk, Jay B, Xu, Haolin, Peterson, Eric D, Bhatt, Deepak L, Fonarow, Gregg C, Smith, Eric E, Matsouaka, Roland, Schwamm, Lee H, and Xian, Ying
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Biomedical and Clinical Sciences ,Oncology and Carcinogenesis ,Clinical Research ,Cardiovascular ,Hematology ,Stroke ,Brain Disorders ,Prevention ,Aged ,Aspirin ,Dual Anti-Platelet Therapy ,Female ,Fibrinolytic Agents ,Humans ,Ischemic Stroke ,Male ,Secondary Prevention ,Treatment Failure ,anticoagulants ,aspirin ,cardiovascular disease ,clopidogrel ,warfarin ,Cardiorespiratory Medicine and Haematology ,Clinical Sciences ,Neurosciences ,Neurology & Neurosurgery ,Clinical sciences ,Allied health and rehabilitation science - Abstract
Background and purposeMany older patients presenting with acute ischemic stroke were already taking aspirin before admission. However, the management strategy for patients with aspirin treatment failure has not been fully established.MethodsWe used data from the American Heart Association Get With The Guidelines Stroke Registry to describe discharge antithrombotic treatment patterns among Medicare beneficiaries with ischemic stroke who were taking aspirin before their stroke and were discharged alive from 1734 hospitals in the United States between October 2012 and December 2017.ResultsOf 261 634 ischemic stroke survivors, 100 016 (38.2%) were taking aspirin monotherapy before stroke. Among them, 44.4% of patients remained on aspirin monotherapy at discharge (20.9% 81 mg, 18.2% 325 mg, 5.3% other or unknown dose). The next most common therapy choice was dual antiplatelet therapy (24.6%), followed by clopidogrel monotherapy (17.8%). The remaining 13.2% of patients were discharged on either aspirin/dipyridamole, warfarin, or nonvitamin K antagonist oral anticoagulants with or without antiplatelet, or no antithrombotic therapy at all.ConclusionsNearly half of patients with ischemic stroke while on preventive therapy with aspirin are discharged on aspirin monotherapy without changing antithrombotic class, while the other half are discharged on clopidogrel monotherapy, dual antiplatelet therapy, or other less common agents. These findings emphasize the need for future research to identify best management strategies for this very common and complex clinical scenario.
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- 2021
8. Achievement of LDL-C
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Navar, Ann Marie, Shah, Nishant P., Shrader, Peter, Thomas, Laine E., Ahmad, Zahid, Allred, Clint, Chamberlain, Alanna M., Chrischilles, Elizabeth A., Dhalwani, Nafeesa, Effron, Mark B., Hayek, Salim, Jones, Laney K., Kalich, Bethany, Shapiro, Michael D., Wójcik, Cezary, and Peterson, Eric D.
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- 2024
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9. Lipid-lowering therapy and LDL-C control for primary prevention in persons with diabetes across 90 health systems in the United States
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Decicco, Emily, Peterson, Eric D., Gupta, Anand, Khalaf Gillard, Kristin, Sarnes, Evelyn, and Navar, Ann Marie
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- 2023
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10. Accuracy of incidental visual coronary artery calcium assessment compared with dedicated coronary artery calcium scoring
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Raygor, Viraj, Hoeting, Natalie, Ayers, Colby, Joshi, Parag, Canan, Arzu, Abbara, Suhny, Assadourian, Joanna N., Khera, Amit, Peterson, Eric D., and Navar, Ann Marie
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- 2023
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11. Generalizability of an EHR-network dataset to the United States for cardiovascular disease conditions: Comparison of Cerner real world data with the national inpatient sample
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Shah, Nishant P., Peterson, Eric D., Page, Courtney, Blanco, Rosalia, and Navar, Ann Marie
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- 2023
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12. Abstract 16147: Racial and Ethnic Differences in the Diagnostic Yield of Cardiomyopathy, Aortopathy, and Arrhythmia Genetic Testing and Frequency of Family Variant Screening
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Carter, Spencer V, Grodin, Justin L, Morales Oyarvide, Vicente, Peterson, Eric D, Khan, Sadiya S, McKnight, Dianalee, Morales, Ana, Russell, Emily, Ting, Yi-Lee, and Navar, Ann Marie M
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- 2023
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13. Abstract 15850: Low Rates of Achievement of Low-Density Lipoprotein Cholesterol Levels <55 mg/dL Among Patients With Atherosclerotic Cardiovascular Disease in the United States: Findings From the Cardiovascular Multicenter Observational Investigation of Lipid Care in the United States-2 Registry
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Navar, Ann Marie, Shah, Nishant, Shrader, Peter, Thomas, Laine E, Ahmad, Zahid, Allred, Clint, Chamberlain, Alanna M, Chrischilles, Elizabeth A, Dhalwani, Nafeesa, Effron, Mark B, Hayek, Salim, Jones, Laney K, Kalich, Bethany, Shapiro, Michael D, Wojcik, Cezary, and Peterson, Eric D
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- 2023
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14. Abstract 15144: The Heartline Experience: Can Digital Health Technology Trials Achieve Long-Term Participant Engagement?
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Nikolovski, Janeta, Navar, Ann Marie, Steinhubl, Steve, Baca-Motes, Katie, Curtis, Anne B, Peterson, Eric D, Lakkireddy, Dhanunjaya, Tarino, Michael, Juan, Stephanie, Damaraju, CV, Wentworth, Dereck, Patel, Mithun, Tavakoli, Cammie, Gibson, Charles M, and Spertus, John
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- 2023
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15. Abstract 12292: Lipid-Lowering Therapy and LDL-C Control for Primary Prevention in Persons With Diabetes Across 90 Health Systems in the United States
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Decicco, Emily, Peterson, Eric D, Gupta, Anand, Gillard, Kristin, Sarnes, Evelyn, and Navar, Ann Marie M
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- 2023
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16. Gaps in Guideline-Based Lipid-Lowering Therapy for Secondary Prevention in the United States: A Retrospective Cohort Study of 322 153 Patients
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Navar, Ann Marie, Kolkailah, Ahmed A., Gupta, Anand, Gillard, Kristin Khalaf, Israel, Marc K., Wang, Yiqing, and Peterson, Eric D.
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- 2023
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17. Evaluation of weight change and cardiometabolic risk factors in a real-world population of US adults with overweight or obesity
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Pagidipati, Neha J., Mulder, Hillary, Chiswell, Karen, Lampron, Zachary, Jones, William S., Machineni, Sriram, Waitman, Lemuel R., Mongraw-Chaffin, Morgana, Waterman, Fanta, Kumar, Neela, Ramasamy, Abhilasha, Smolarz, Gabriel, Peterson, Eric D., and O'Brien, Emily
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- 2023
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18. Does early detection of atrial fibrillation reduce the risk of thromboembolic events? Rationale and design of the Heartline study
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Gibson, C. Michael, Steinhubl, Steven, Lakkireddy, Dhanunjaya, Turakhia, Mintu P., Passman, Rod, Jones, W. Schuyler, Bunch, T. Jared, Curtis, Anne B., Peterson, Eric D., Ruskin, Jeremy, Saxon, Leslie, Tarino, Michael, Tarakji, Khaldoun G., Marrouche, Nassir, Patel, Mithun, Harxhi, Ante, Kaul, Simrati, Nikolovski, Janeta, Juan, Stephanie, Wildenhaus, Kevin, Damaraju, C.V., and Spertus, John A.
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- 2023
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19. Shared decision-making in atrial fibrillation: patient-reported involvement in treatment decisions.
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Ali-Ahmed, Fatima, Pieper, Karen, North, Rebecca, Allen, Larry A, Chan, Paul S, Ezekowitz, Michael D, Fonarow, Gregg C, Freeman, James V, Go, Alan S, Gersh, Bernard J, Kowey, Peter R, Mahaffey, Kenneth W, Naccarelli, Gerald V, Pokorney, Sean D, Reiffel, James A, Singer, Daniel E, Steinberg, Benjamin A, Peterson, Eric D, Piccini, Jonathan P, and O’Brien, Emily C
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Health Services and Systems ,Biomedical and Clinical Sciences ,Health Sciences ,Basic Behavioral and Social Science ,Cardiovascular ,Behavioral and Social Science ,Clinical Research ,Heart Disease ,Aged ,Atrial Fibrillation ,Clinical Decision-Making ,Disease Management ,Female ,Humans ,Male ,Middle Aged ,Patient Participation ,Patient Reported Outcome Measures ,Stroke ,Patient-reported involvement in treatment decisions ,Quality of care ,Shared decision-making ,Stroke prevention ,Cardiovascular medicine and haematology ,Public health - Abstract
AimsTo determine the extent of shared decision-making (SDM), during selection of oral anticoagulant (OAC) and rhythm control treatments, in patients with newly diagnosed atrial fibrillation (AF).Methods and resultsWe evaluated survey data from 1006 patients with new-onset AF enrolled at 56 US sites participating in the SATELLITE substudy of the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT II). Patients completed surveys at enrolment and at 6-month follow-up. Patients were asked about who made their AF treatment decisions. Shared decision-making was classified as one that the patient felt was an autonomous decision or a shared decision with their healthcare provider (HCP). Approximately half of patients reported that their OAC treatment decisions were made entirely by their HCP. Compared with those reporting no SDM, patients reporting SDM for OAC were more often female (47.2% vs. 38.4%), while patients reporting SDM for rhythm control were more often male (62.2% vs. 57.6%). The most important factors cited by patients during decision-making for OAC were reducing stroke and bleeding risk, and their HCP's recommendations. After adjustment, patients with self-reported understanding of OAC, and rhythm control options, had higher odds of having participated in SDM [odds ratio (OR) 2.54, confidence interval (CI): 1.75-3.68 and OR 2.36, CI: 1.50-3.71, both P ≤ 0.001, respectively].ConclusionShared decision-making is not widely implemented in contemporary AF practice. Patient understanding about available therapeutic options is associated with a more than a two-fold higher likelihood of SDM, and may be a potential target for future interventions.
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- 2020
20. Cardiovascular Biomarkers and Imaging in Older Adults JACC Council Perspectives
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Forman, Daniel E, de Lemos, James A, Shaw, Leslee J, Reuben, David B, Lyubarova, Radmila, Peterson, Eric D, Spertus, John A, Zieman, Susan, Salive, Marcel E, Rich, Michael W, and Council, Geriatric Cardiology Section Leadership
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Biomedical and Clinical Sciences ,Clinical Sciences ,Aging ,Cardiovascular ,Heart Disease ,4.1 Discovery and preclinical testing of markers and technologies ,Detection ,screening and diagnosis ,4.2 Evaluation of markers and technologies ,Good Health and Well Being ,Aged ,Biomarkers ,Cardiac Imaging Techniques ,Exercise Test ,Humans ,aging ,biomarkers ,cardiovascular testing ,imaging ,shared decision making ,stress testing ,Geriatric Cardiology Section Leadership Council ,Cardiorespiratory Medicine and Haematology ,Public Health and Health Services ,Cardiovascular System & Hematology ,Cardiovascular medicine and haematology - Abstract
Whereas the burgeoning population of older adults is intrinsically vulnerable to cardiovascular disease, the utility of many management precepts that were validated in younger adults is often unclear. Whereas biomarker- and imaging-based tests are a major part of cardiovascular disease care, basic assumptions about their use and efficacy cannot be simply extrapolated to many older adults. Biology, physiology, and body composition change with aging, with important influences on cardiovascular disease testing procedures and their interpretation. Furthermore, clinical priorities of older adults are more heterogeneous, potentially undercutting the utility of testing data that are collected. The American College of Cardiology and the National Institutes on Aging, in collaboration with the American Geriatrics Society, convened, at the American College of Cardiology Heart House, a 2-day multidisciplinary workshop, "Diagnostic Testing in Older Adults with Cardiovascular Disease," to address these issues. This review summarizes key concepts, clinical limitations, and important opportunities for research.
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- 2020
21. Risk of major cardiovascular and neurologic events with obstructive sleep apnea among patients with atrial fibrillation
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Dalgaard, Frederik, North, Rebecca, Pieper, Karen, Fonarow, Gregg C, Kowey, Peter R, Gersh, Bernard J, Mahaffey, Kenneth W, Pokorney, Sean, Steinberg, Benjamin A, Naccarrelli, Gerald, Allen, Larry A, Reiffel, James A, Ezekowitz, Michael, Singer, Daniel E, Chan, Paul S, Peterson, Eric D, and Piccini, Jonathan P
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Biomedical and Clinical Sciences ,Medical Physiology ,Cardiovascular Medicine and Haematology ,Cardiovascular ,Prevention ,Sleep Research ,Brain Disorders ,Patient Safety ,Heart Disease ,Clinical Research ,Lung ,Detection ,screening and diagnosis ,4.2 Evaluation of markers and technologies ,Good Health and Well Being ,Aged ,Aged ,80 and over ,Atrial Fibrillation ,Cardiovascular Diseases ,Cohort Studies ,Female ,Humans ,Male ,Middle Aged ,Nervous System Diseases ,Retrospective Studies ,Risk Assessment ,Sleep Apnea ,Obstructive ,Cardiorespiratory Medicine and Haematology ,Public Health and Health Services ,Cardiovascular System & Hematology ,Cardiovascular medicine and haematology - Abstract
BackgroundObstructive sleep apnea (OSA) is a known risk factor for atrial fibrillation (AF). However, it remains unclear whether OSA is independently associated with worse cardiovascular and neurological outcomes in patients with AF.MethodsWe used the ORBIT-AF I and ORBIT-AF II to conduct a retrospective cohort study of 22,760 patients with AF with and without OSA. Adjusted multivariable Cox proportional hazards models was used to determine whether OSA was associated with increased risk for major adverse cardiac and neurologic events (MACNEs) (cardiovascular death, myocardial infarction, stroke/transient ischemic attack/non-central nervous system embolism (stroke/SE), and new-onset heart failure], combined and individually.ResultsA total of 4,045 (17.8%) patients had OSA at baseline. Median follow-up time was 1.5 (interquartile range: 1-2.2) years, and 1,895 patients experienced a MACNE. OSA patients were younger (median [interquartile range] 68 [61-75] years vs 74 [66-81] years), were more likely male (70.7% vs 55.3%), and had increased body mass index (median 34.6 kg/m2 [29.8-40.2] vs 28.7 kg/m2 [25.2-33.0]). Those with OSA had a higher prevalence of concomitant comorbidities such as diabetes, chronic obstructive pulmonary disease, and heart failure. OSA patients had higher use of antithrombotic therapy. After adjustment, the presence of OSA was significantly associated with MACNE (hazard ratio: 1.16 [95% CI: 1.03-1.31], P = .011). OSA was also an independent risk factor for stroke/SE beyond the CHA2DS2-VASc risk factors (HR: 1.38 [95% CI 1.12-1.70], P = .003) but not cardiovascular death, myocardial infarction, new-onset heart failure, or major bleeding.ConclusionsAmong patients with AF, OSA is an independent risk factor for MACNE and, more specifically, stroke/SE.
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- 2020
22. Factors Associated With Large Improvements in Health-Related Quality of Life in Patients With Atrial Fibrillation
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Steinberg, Benjamin A, Holmes, DaJuanicia N, Pieper, Karen, Allen, Larry A, Chan, Paul S, Ezekowitz, Michael D, Freeman, James V, Fonarow, Gregg C, Gersh, Bernard J, Hylek, Elaine M, Kowey, Peter R, Mahaffey, Kenneth W, Naccarelli, Gerald, Reiffel, James, Singer, Daniel E, Peterson, Eric D, Piccini, Jonathan P, Mendelson, R, Nahhas, A, Neutel, J, Padanilam, B, Pan, D, Poock, J, Raffetto, J, Greengold, R, Roan, P, Saba, F, Sackett, M, Schneider, R, Seymour, Z, Shanes, J, Shoemaker, J, Simms, V, Smiley, N, Smith, D, Snipes, C, Sotolongo, R, Staniloae, C, Stoltz, S, Suresh, DP, Tak, T, Tannenbaum, A, Turk, S, Vora, K, Randhawa, P, Zebrack, J, Silva, E, Riley, E, Weinstein, D, Vasiliauskas, T, Goldbarg, S, Hayward, D, Yarlagadda, C, Laurion, D, Osunkoya, A, Burns, R, Castor, T, Spiller, D, Luttman, C, Anton, S, McGarvey, J, Guthrie, R, Deriso, G, Flood, R, Fleischer, L, Fierstein, JS, Aggarwal, R, Jacobs, G, Adjei, N, Akyea-Djamson, A, Alfieri, A, Bacon, J, Bedwell, N, Berger, P, Berry, J, Bhagwat, R, Bloom, S, Boccalandro, F, Capo, J, Kapadia, S, Casanova, R, Morriss III, JE, Christensen, T, Elsen, J, Farsad, R, Fox, D, Frandsen, B, Gelernt, M, Gill, S, Grubb, S, Hall, C, Harris, H, Hotchkiss, D, Ip, J, Jaffrani, N, Jones, A, Kazmierski, J, Waxman, F, Kneller, GL, and Labroo, A
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Biomedical and Clinical Sciences ,Clinical Sciences ,Heart Disease ,Substance Misuse ,Genetics ,Health Services ,Cardiovascular ,Clinical Research ,Good Health and Well Being ,Aged ,Aged ,80 and over ,Anti-Arrhythmia Agents ,Atrial Fibrillation ,Catheter Ablation ,Comorbidity ,Electric Countershock ,Female ,Health Status ,Heart Rate ,Humans ,Male ,Outpatients ,Quality of Life ,Recovery of Function ,Registries ,Risk Factors ,Time Factors ,Treatment Outcome ,United States ,ORBIT-AF (Outcomes Registry for Better Informed Treatment of Atrial Fibrillation) Investigators and Patients ,atrial fibrillation ,cardiac resynchronization therapy ,health status ,patient-reported outcomes ,quality of life ,Cardiorespiratory Medicine and Haematology ,Medical Physiology ,Cardiovascular System & Hematology ,Cardiovascular medicine and haematology ,Clinical sciences ,Medical physiology - Abstract
BackgroundAtrial fibrillation (AF) adversely impacts health-related quality of life (hrQoL). While some patients demonstrate improvements in hrQoL, the factors associated with large improvements in hrQoL are not well described.MethodsWe assessed factors associated with a 1-year increase in the Atrial Fibrillation Effect on Quality-of-Life score of 1 SD (≥18 points; 3× clinically important difference), among outpatients in the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation I registry.ResultsOverall, 28% (181/636) of patients had such a hrQoL improvement. Compared with patients not showing large hrQoL improvement, they were of similar age (median 73 versus 74, P=0.3), equally likely to be female (44% versus 48%, P=0.3), but more likely to have newly diagnosed AF at baseline (18% versus 8%; P=0.0004), prior antiarrhythmic drug use (52% versus 40%, P=0.005), baseline antiarrhythmic drug use (34.8% versus 26.8%, P=0.045), and more likely to undergo AF-related procedures during follow-up (AF ablation: 6.6% versus 2.0%, P=0.003; cardioversion: 12.2% versus 5.9%, P=0.008). In multivariable analysis, a history of alcohol abuse (adjusted OR, 2.41; P=0.01) and increased baseline diastolic blood pressure (adjusted OR, 1.23 per 10-point increase and >65 mm Hg; P=0.04) were associated with large improvements in hrQoL at 1 year, whereas patients with prior stroke/transient ischemic attack, chronic obstructive pulmonary disease, and peripheral arterial disease were less likely to improve (P
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- 2020
23. Impact of a Copayment Reduction Intervention on Medication Persistence and Cardiovascular Events in Hospitals With and Without Prior Medication Financial Assistance Programs
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Doll, Jacob A, Kaltenbach, Lisa A, Anstrom, Kevin J, Cannon, Christopher P, Henry, Timothy D, Fonarow, Gregg C, Choudhry, Niteesh K, Fonseca, Eileen, Bhalla, Narinder, Eudicone, James M, Peterson, Eric D, and Wang, Tracy Y
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Cardiovascular ,Clinical Trials and Supportive Activities ,Clinical Research ,Evaluation of treatments and therapeutic interventions ,6.1 Pharmaceuticals ,Good Health and Well Being ,Aged ,Cost-Benefit Analysis ,Deductibles and Coinsurance ,Drug Costs ,Female ,Health Expenditures ,Humans ,Male ,Medication Adherence ,Middle Aged ,Myocardial Infarction ,Platelet Aggregation Inhibitors ,Purinergic P2Y Receptor Antagonists ,Quality Improvement ,Quality Indicators ,Health Care ,Time Factors ,Treatment Outcome ,United States ,medication adherence ,myocardial infarction ,quality improvement ,Cardiorespiratory Medicine and Haematology - Abstract
Background Hospitals commonly provide a short-term supply of free P2Y12 inhibitors at discharge after myocardial infarction, but it is unclear if these programs improve medication persistence and outcomes. The ARTEMIS (Affordability and Real-World Antiplatelet Treatment Effectiveness After Myocardial Infarction Study) trial randomized hospitals to usual care versus waived P2Y12 inhibitor copayment costs for 1-year post-myocardial infarction. Whether the impact of this intervention differed between hospitals with and without pre-existing medication assistance programs is unknown. Methods and Results In this post hoc analysis of the ARTEMIS trial, we examined the associations of pre-study free medication programs and the randomized copayment voucher intervention with P2Y12 inhibitor persistence (measured by pharmacy fills and patient report) and major adverse cardiovascular events using logistic regression models including a propensity score. Among 262 hospitals, 129 (49%) offered pre-study free medication assistance. One-year P2Y12 inhibitor persistence and major adverse cardiovascular events risks were similar between patients treated at hospitals with and without free medication programs (adjusted odds ratio 0.93, 95% CI, 0.82-1.05 and hazard ratio 0.92, 95% CI, 0.80-1.07, respectively). The randomized copayment voucher intervention improved persistence, assessed by pharmacy fills, in both hospitals with (53.6% versus 44.0%, adjusted odds ratio 1.45, 95% CI, 1.20-1.75) and without (59.0% versus 48.3%, adjusted odds ratio 1.46, 95% CI, 1.25-1.70) free medication programs (Pinteraction=0.71). Differences in patient-reported persistence were not significant after adjustment. Conclusions While hospitals commonly report the ability to provide free short-term P2Y12 inhibitors, we did not find association of this with medication persistence or major adverse cardiovascular events among patients with insurance coverage for prescription medication enrolled in the ARTEMIS trial. An intervention that provided copayment assistance vouchers for 1 year was successful in improving medication persistence in hospitals with and without pre-existing short-term medication programs. Registration URL: https://www.clinicaltrials.gov/. Unique identifier: NCT02406677.
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- 2020
24. Thrombolytic therapy in older acute ischemic stroke patients with gastrointestinal malignancy or recent bleeding
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Inohara, Taku, Liang, Li, Kosinski, Andrzej S, Smith, Eric E, Schwamm, Lee H, Hernandez, Adrian F, Bhatt, Deepak L, Fonarow, Gregg C, Peterson, Eric D, and Xian, Ying
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Clinical Research ,Aging ,Brain Disorders ,Stroke ,Digestive Diseases ,Good Health and Well Being ,Recombinant tissue plasminogen activator ,thrombolysis ,stroke ,contraindication ,eligibility criteria - Abstract
BackgroundThere are limited data on the safety of intravenous recombinant tissue plasminogen activator (rtPA) for treating acute ischemic stroke in patients with gastrointestinal malignancy or recent gastrointestinal bleeding within 21 days of their index stroke.AimsTo evaluate clinical outcomes in patients treated with rtPA for acute ischemic stroke who had gastrointestinal malignancy or recent gastrointestinal bleeding.MethodsWe identified patients who were treated with rtPA for acute ischemic stroke between 2/2009 and 12/2015 from the Get With The Guidelines-Stroke linked to Medicare claims data. Gastrointestinal malignancy and recent gastrointestinal bleeding were defined as any gastrointestinal malignancy hospitalisation within one year prior to acute ischemic stroke and gastrointestinal bleeding hospitalisation within 21 days prior to acute ischemic stroke, respectively. Outcomes of interest included in-hospital mortality and bleeding complications.ResultsAmong 40,396 patients aged 65 years or older treated with rtPA for acute ischemic stroke from 1522 sites (mean age [SD] 81.0 [8.1] years; 41.9% women), 136 (0.3%) had gastrointestinal malignancy (n = 96) or recent gastrointestinal bleeding (n = 43). Patients with gastrointestinal malignancy or bleeding had more severe stroke than those without (median NIHSS [interquartile range]: 14.0 [8.0-19.0] vs. 11.0 [6.0-18.0]). The rates of in-hospital mortality and life-threatening systemic haemorrhage were not significantly different between those with and without gastrointestinal malignancy or bleeding (mortality: 10.3% vs. 9.0%, adjusted odds ratio [aOR] 1.01, 95%CI 0.58-1.75; bleeding: 2.3% vs. 1.2%, aOR 1.72, 95%CI 0.58-5.11).ConclusionsIn this observational cohort, we did not find increased risk of in-hospital mortality and bleeding in rtPA-treated patients with gastrointestinal malignancy or recent gastrointestinal bleeding.
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- 2020
25. Guideline-directed therapies for comorbidities and clinical outcomes among individuals with atrial fibrillation
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Loring, Zak, Shrader, Peter, Allen, Larry A, Blanco, Rosalia, Chan, Paul S, Ezekowitz, Michael D, Fonarow, Gregg C, Freeman, James V, Gersh, Bernard J, Mahaffey, Kenneth W, Naccarelli, Gerald V, Pieper, Karen, Reiffel, James A, Singer, Daniel E, Steinberg, Benjamin A, Thomas, Laine E, Peterson, Eric D, and Piccini, Jonathan P
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Biomedical and Clinical Sciences ,Cardiovascular Medicine and Haematology ,Cardiovascular ,Clinical Research ,Lung ,Heart Disease ,Sleep Research ,Detection ,screening and diagnosis ,Aetiology ,4.2 Evaluation of markers and technologies ,2.1 Biological and endogenous factors ,Good Health and Well Being ,Aged ,Atrial Fibrillation ,Cardiovascular Diseases ,Cause of Death ,Comorbidity ,Coronary Artery Disease ,Diabetes Mellitus ,Disease Progression ,Embolism ,Female ,Guideline Adherence ,Heart Failure ,Humans ,Hyperlipidemias ,Hypertension ,Intracranial Embolism ,Male ,Peripheral Nervous System Diseases ,Peripheral Vascular Diseases ,Registries ,Sleep Apnea ,Obstructive ,Treatment Outcome ,Cardiorespiratory Medicine and Haematology ,Public Health and Health Services ,Cardiovascular System & Hematology ,Cardiovascular medicine and haematology - Abstract
BackgroundComorbidities are common in patients with atrial fibrillation (AF) and affect prognosis, yet are often undertreated. However, contemporary rates of use of guideline-directed therapies (GDT) for non-AF comorbidities and their association with outcomes are not well described.MethodsWe used the Outcomes Registry for Better Informed Treatment of AF (ORBIT-AF) to test the association between GDT for non-AF comorbidities and major adverse cardiac or neurovascular events (MACNE; cardiovascular death, myocardial infarction, stroke/thromboembolism, or new-onset heart failure), all-cause mortality, new-onset heart failure, and AF progression. Adjustment was performed using Cox proportional hazards models and logistic regression.ResultsOnly 6,782 (33%) of the 20,434 patients eligible for 1 or more GDT for non-AF comorbidities received all indicated therapies. Use of all comorbidity-specific GDT was highest for patients with hyperlipidemia (75.6%) and lowest for those with diabetes mellitus (43.1%). Use of "all eligible" GDT was associated with a nonsignificant trend toward lower rates of MACNE (HR 0.90 [0.79-1.02]) and all-cause mortality (HR 0.90 [0.80-1.01]). Use of GDT for heart failure was associated with a lower risk of all-cause mortality (HR 0.77 [0.67-0.89]), and treatment of obstructive sleep apnea was associated with a lower risk of AF progression (OR 0.75 [0.62-0.90]).ConclusionsIn AF patients, there is underuse of GDT for non-AF comorbidities. The association between GDT use and outcomes was strongest in heart failure and obstructive sleep apnea patients where use of GDT was associated with lower mortality and less AF progression.
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- 2020
26. Rhythm Control Versus Rate Control in Patients With Atrial Fibrillation and Heart Failure With Preserved Ejection Fraction: Insights From Get With The Guidelines—Heart Failure
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Kelly, Jacob P, DeVore, Adam D, Wu, JingJing, Hammill, Bradley G, Sharma, Abhinav, Cooper, Lauren B, Felker, G Michael, Piccini, Jonathan P, Allen, Larry A, Heidenreich, Paul A, Peterson, Eric D, Yancy, Clyde W, Fonarow, Gregg C, and Hernandez, Adrian F
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Biomedical and Clinical Sciences ,Cardiovascular Medicine and Haematology ,Heart Disease ,Cardiovascular ,Aging ,Clinical Research ,Aged ,Aged ,80 and over ,Atrial Fibrillation ,Female ,Heart Failure ,Heart Rate ,Humans ,Male ,Practice Guidelines as Topic ,Retrospective Studies ,Stroke Volume ,atrial fibrillation ,heart failure with preserved ejection fraction ,rate control ,rhythm control ,Cardiorespiratory Medicine and Haematology ,Cardiovascular medicine and haematology - Abstract
Background Limited data exist to guide treatment for patients with heart failure with preserved ejection fraction and atrial fibrillation, including the important decision regarding rate versus rhythm control. Methods and Results We analyzed the Get With The Guidelines-Heart Failure (GWTG-HF) registry linked to Medicare claims data from 2008 to 2014 to describe current treatments for rate versus rhythm control and subsequent outcomes in patients with heart failure with preserved ejection fraction and atrial fibrillation using inverse probability weighted analysis. Rhythm control was defined as use of an antiarrhythmic medication, cardioversion, or AF ablation or surgery. Rate control was defined as use of any combination of β-blocker, calcium channel blocker, and digoxin without evidence of rhythm control. Among 15 682 fee-for-service Medicare patients, at the time of discharge, 1857 were treated with rhythm control and 13 825 with rate control, with minimal differences in baseline characteristics between groups. There was higher all-cause death at 1 year in the rate control compared with the rhythm control group (37.5% and 30.8%, respectively, P
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- 2019
27. Representativeness of a Heart Failure Trial by Race and Sex Results From ASCEND-HF and GWTG-HF
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Greene, Stephen J, DeVore, Adam D, Sheng, Shubin, Fonarow, Gregg C, Butler, Javed, Califf, Robert M, Hernandez, Adrian F, Matsouaka, Roland A, Samman Tahhan, Ayman, Thomas, Kevin L, Vaduganathan, Muthiah, Yancy, Clyde W, Peterson, Eric D, O'Connor, Christopher M, and Mentz, Robert J
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Heart Disease ,Clinical Research ,Clinical Trials and Supportive Activities ,Cardiovascular ,Good Health and Well Being ,Black or African American ,Aged ,Aged ,80 and over ,Female ,Heart Failure ,Humans ,Male ,Natriuretic Agents ,Natriuretic Peptide ,Brain ,Patient Selection ,Randomized Controlled Trials as Topic ,Sex Distribution ,White People ,enrollment ,heart failure ,race ,sex ,trial ,Cardiorespiratory Medicine and Haematology - Abstract
ObjectivesThis study sought to determine the degree to which U.S. patients enrolled in a heart failure (HF) trial represent patients in routine U.S. clinical practice according to race and sex.BackgroundBlack patients and women are frequently under-represented in HF clinical trials. However, the degree to which black patients and women enrolled in trials represent such patients in routine practice is unclear.MethodsThe ASCEND-HF (Acute Study of Clinical Effectiveness of Nesiritide in Decompensated Heart Failure) trial randomized patients hospitalized for HF to receive nesiritide or placebo from May 2007 to August 2010 and was neutral for clinical endpoints. This analysis compared non-Hispanic white (n = 1,494) and black (n = 1,012) patients enrolled in ASCEND-HF from the U.S. versus non-Hispanic white and black patients included in a U.S. hospitalized HF registry (i.e., Get With The Guidelines-Heart Failure [GWTG-HF]) during the ASCEND-HF enrollment period and meeting trial eligibility criteria.ResultsAmong 79,291 white and black registry patients, 49,063 (62%) met trial eligibility criteria (white, n = 37,883 [77.2%]; black, n = 11,180 [22.8%]). Women represented 35% and 49% of the ASCEND-HF and trial-eligible GWTG-HF cohorts, respectively. Compared with trial-enrolled patients, trial-eligible GWTG-HF patients tended to be older with higher blood pressure and higher ejection fraction. Trial-eligible patients had higher in-hospital mortality (2.3% vs. 1.3%), 30-day readmission (20.2% vs. 16.8%), and 180-day mortality (21.2% vs. 18.6%) than those enrolled in the trial (all p
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- 2019
28. Contemporary patterns of lipoprotein(a) testing and associated clinical care and outcomes
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Kelsey, Michelle D., Mulder, Hillary, Chiswell, Karen, Lampron, Zachary M., Nilles, Ester, Kulinski, Jacquelyn P., Joshi, Parag H., Jones, W. Schuyler, Chamberlain, Alanna M., Leucker, Thorsten M., Hwang, Wenke, Milks, M. Wesley, Paranjape, Anuradha, Obeid, Jihad S., Linton, MacRae F., Kent, Shia T., Peterson, Eric D., O'Brien, Emily C., and Pagidipati, Neha J.
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- 2023
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29. Residual stroke risk despite oral anticoagulation in patients with atrial fibrillation
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Carlisle, Matthew A., Shrader, Peter, Fudim, Marat, Pieper, Karen S., Blanco, Rosalia G., Fonarow, Gregg C., Naccarelli, Gerald V., Gersh, Bernard J., Reiffel, James A., Kowey, Peter R., Steinberg, Benjamin A., Freeman, James V., Ezekowitz, Michael D., Singer, Daniel E., Allen, Larry A., Chan, Paul S., Pokorney, Sean D., Peterson, Eric D., and Piccini, Jonathan P.
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- 2022
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30. Readmissions After Acute Myocardial Infarction: How Often Do Patients Return to the Discharging Hospital?
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Rymer, Jennifer A, Chen, Anita Y, Thomas, Laine, Fonarow, Gregg C, Peterson, Eric D, and Wang, Tracy Y
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Humans ,Myocardial Infarction ,Prognosis ,Length of Stay ,Patient Discharge ,Patient Readmission ,Patient Transfer ,Registries ,Cause of Death ,Risk Assessment ,Risk Factors ,Retrospective Studies ,Time Factors ,Aged ,Aged ,80 and over ,Medicare ,Continuity of Patient Care ,United States ,Female ,Male ,Catchment Area ,Health ,length of stay ,mortality ,myocardial infarction ,readmission ,Cardiorespiratory Medicine and Haematology - Abstract
Background When patients require readmission after a recent myocardial infarction (MI), returning to the discharging (index) hospital may be associated with better outcomes as a result of greater continuity in care. However, little evidence exists to answer this frequent patient question. Methods and Results Among Medicare patients aged ≥65 years discharged home alive post-MI from 491 US hospitals in the ACTION (Acute Coronary Treatment Intervention Outcomes Network) Registry, we compared reason for readmission, duration of rehospitalization, and 30-day mortality between patients readmitted to the index versus nonindex hospital within 30 days of index MI discharge. Among 53 471 MI patients, 7715 (14%) were readmitted within 30 days, and most readmitted patients (73%) returned to the discharging hospital. Reason for readmission was not significantly associated with location of readmission. In multivariable modeling, the strongest factors associated with readmission to a nonindex hospital were distance from the discharging hospital, transfer-in during the index MI hospitalization, and frequency of nonindex hospital admissions in the year preceding to the index MI. Duration of rehospitalization did not differ significantly between patients readmitted to the index versus nonindex hospital (median, 4 versus 3 days; P=0.17). Mortality risk was also not significantly different between patients readmitted to the index versus nonindex hospital overall (7.4 versus 7.7%; adjusted odds ratio, 0.89; 95% CI, 0.73-1.10) and when stratified by reason for readmission (P for interaction=0.61). Conclusions Post-MI readmissions did not differ in reason for readmission, duration of rehospitalization, or associated mortality when compared between patients who returned to the discharging hospital and those who sought care elsewhere.
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- 2019
31. Recent Myocardial Infarction is Associated With Increased Risk in Older Adults With Acute Ischemic Stroke Receiving Thrombolytic Therapy
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Inohara, Taku, Liang, Li, Kosinski, Andrzej S, Smith, Eric E, Schwamm, Lee H, Hernandez, Adrian F, Bhatt, Deepak L, Fonarow, Gregg C, Peterson, Eric D, and Xian, Ying
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Biomedical and Clinical Sciences ,Clinical Sciences ,Stroke ,Heart Disease ,Aging ,Brain Disorders ,Cardiovascular ,Heart Disease - Coronary Heart Disease ,Good Health and Well Being ,Aged ,Aged ,80 and over ,Brain Ischemia ,Cohort Studies ,Female ,Fibrinolytic Agents ,Hospital Mortality ,Humans ,Male ,Myocardial Infarction ,Retrospective Studies ,Risk Assessment ,Thrombolytic Therapy ,Time Factors ,Tissue Plasminogen Activator ,contraindication ,eligibility criteria ,recombinant tissue plasminogen activator ,stroke ,thrombolysis ,Cardiorespiratory Medicine and Haematology ,Cardiovascular medicine and haematology - Abstract
Background Intravenous recombinant tissue-type plasminogen activator (rtPA) remains the only medical therapy to improve outcomes for acute ischemic stroke (AIS), but the safety of rtPA in AIS patients with a history of recent myocardial infarction (MI) remains controversial. Methods and Results We sought to determine whether the presence of recent MI would alter the risk of mortality and rtPA-related complications. Multivariate logistic regression models were used to compare in-hospital outcomes between rtPA-treated AIS patients with recent MI within 3 months and those with no history of MI from the Get With The Guidelines-Stroke hospitals between February 2009 and December 2015. Among 40 396 AIS patients aged ≥65 years treated with rtPA, 241 (0.6%) had recent MI, of which 19.5% were ST-segment-elevation myocardial infarction. Patients with recent MI had more severe stroke than those without (median National Institutes of Health Stroke Scale [interquartile range]: 13.0 [7.0-20.0] versus 11.0 [6.0-18.0]). Recent MI was associated with an increased risk of mortality compared with no history of MI (17.4% versus 9.0%; adjusted odds ratio 1.60 [95% CI, 1.10-2.33]; P=0.014), but no statistically significant differences in rtPA-related complications (13.5% versus 9.4%; adjusted odds ratio 1.28 [0.88-1.86]; P=0.19). Recent ST-segment-elevation myocardial infarction was associated with higher risk of death and rtPA-related complications, but non-ST-segment-elevation myocardial infarction was not. Conclusions Among older AIS patients treated with rtPA, recent MI was associated with an increased risk of in-hospital mortality. Further investigations are necessary to determine whether the benefit of rtPA outweighs its risk among AIS patients with recent MI.
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- 2019
32. Intravenous Tissue Plasminogen Activator in Stroke Mimics
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Ali-Ahmed, Fatima, Federspiel, Jerome J, Liang, Li, Xu, Haolin, Sevilis, Theresa, Hernandez, Adrian F, Kosinski, Andrzej S, Prvu Bettger, Janet, Smith, Eric E, Bhatt, Deepak L, Schwamm, Lee H, Fonarow, Gregg C, Peterson, Eric D, and Xian, Ying
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Prevention ,Stroke ,Neurosciences ,Brain Disorders ,Clinical Research ,Good Health and Well Being ,Administration ,Intravenous ,Adult ,Aged ,Aged ,80 and over ,Brain Ischemia ,Diagnosis ,Differential ,Female ,Fibrinolytic Agents ,Humans ,Intracranial Hemorrhages ,Male ,Middle Aged ,Predictive Value of Tests ,Registries ,Risk Assessment ,Risk Factors ,Thrombolytic Therapy ,Tissue Plasminogen Activator ,Treatment Outcome ,United States ,Unnecessary Procedures ,hospital mortality ,intracranial hemorrhage ,seizure ,stroke ,tissue plasminogen activator ,Cardiorespiratory Medicine and Haematology ,Public Health and Health Services ,Cardiovascular System & Hematology - Abstract
BackgroundThe necessity for rapid evaluation and treatment of acute ischemic stroke with intravenous tPA (tissue-type plasminogen activator) may increase the risk of administrating tPA to patients presenting with noncerebrovascular conditions that closely resemble stroke (stroke mimics). However, there are limited data on thrombolysis safety in stroke mimics.Methods and resultsUsing data from the Get With The Guidelines-Stroke Registry, we identified 72 582 patients with suspected ischemic stroke treated with tPA from 485 US hospitals between January 2010 and December 2017. We documented the use of tPA in stroke mimics, defined as patients who present with stroke-like symptoms, but after workup are determined not to have suffered from a stroke or transient ischemic attack, and compared characteristics and outcomes in stroke mimics versus those with ischemic stroke. Overall, 3.5% of tPA treatments were given to stroke mimics. Among them, 38.2% had a final nonstroke diagnoses of migraine, functional disorder, seizure, and electrolyte or metabolic imbalance. Compared with tPA-treated true ischemic strokes, tPA-treated mimics were younger (median 54 versus 71 years), had a less severe National Institute of Health Stroke Scale (median 6 versus 8), and a lower prevalence of cardiovascular risk factors, except for a higher prevalence of prior stroke/transient ischemic attack (31.3% versus 26.1%, all P
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- 2019
33. Intravenous Tissue-Type Plasminogen Activator in Acute Ischemic Stroke Patients With History of Stroke Plus Diabetes Mellitus
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Ehrlich, Matthew E, Liang, Li, Xu, Haolin, Kosinski, Andrzej S, Hernandez, Adrian F, Schwamm, Lee H, Smith, Eric E, Fonarow, Gregg C, Bhatt, Deepak L, Peterson, Eric D, and Xian, Ying
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Brain Disorders ,Neurosciences ,Stroke ,Diabetes ,Clinical Research ,Good Health and Well Being ,Acute Disease ,Administration ,Intravenous ,Aged ,Aged ,80 and over ,Brain Ischemia ,Diabetes Complications ,Disease-Free Survival ,Hospital Mortality ,Humans ,Middle Aged ,Survival Rate ,Time Factors ,Tissue Plasminogen Activator ,diabetes mellitus ,stroke ,thrombolysis ,tissue-type plasminogen activator ,Cardiorespiratory Medicine and Haematology ,Clinical Sciences ,Neurology & Neurosurgery - Abstract
Background and Purpose- Acute ischemic stroke patients with history of prior ischemic stroke plus concomitant diabetes mellitus (DM) were excluded from the ECASS III trial (European Cooperative Acute Stroke Study) because of safety concerns. However, there are few data on use of intravenous tissue-type plasminogen activator and symptomatic intracerebral hemorrhage or outcomes in this population. Methods- Using data from the Get With The Guidelines-Stroke Registry between February 2009 and September 2017 (n=1619 hospitals), we examined characteristics and outcomes among patients with acute ischemic stroke treated with tissue-type plasminogen activator within the 3- to 4.5-hour window who had a history of stroke plus diabetes mellitus (HxS+DM) (n=2129) versus those without either history (n=16 690). Results- Compared with patients without either history, those with both prior stroke and DM treated with tissue-type plasminogen activator after an acute ischemic stroke had a higher prevalence of cardiovascular risk factors in addition to history of stroke, DM, and more severe stroke (National Institutes of Health Stroke Scale: median, 8 [interquartile range, 5-15] versus 7 [4-13]). The unadjusted rates of symptomatic intracerebral hemorrhage and in-hospital mortality were 4.3% (HxS+DM) versus 3.8% (without either history; P=0.31) and 6.2% versus 5.5% ( P=0.20), respectively. These differences were not statistically significant after risk adjustment (symptomatic intracerebral hemorrhage: adjusted odds ratio, 0.79 [95% CI, 0.51-1.21]; P=0.28; in-hospital mortality: odds ratio, 0.77 [95% CI, 0.52-1.14]; P=0.19). Unadjusted rate of functional independence (modified Rankin Scale score, 0-2) at discharge was lower in those with HxS+DM (30.9% HxS+DM versus 44.8% without either history; P≤0.0001), and this difference persisted after adjusting for baseline clinical factors (adjusted odds ratio, 0.76 [95% CI, 0.59-0.99]; P=0.04). Conclusions- Among patients with acute ischemic stroke treated with intravenous tissue-type plasminogen activator within the 3- to 4.5-hour window, HxS+DM was not associated with statistically significant increased symptomatic intracerebral hemorrhage or mortality risk.
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- 2019
34. Comparison of Patient‐Reported Care Satisfaction, Quality of Warfarin Therapy, and Outcomes of Atrial Fibrillation: Findings From the ORBIT‐AF Registry
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Perino, Alexander C, Shrader, Peter, Turakhia, Mintu P, Ansell, Jack E, Gersh, Bernard J, Fonarow, Gregg C, Go, Alan S, Kaiser, Daniel W, Hylek, Elaine M, Kowey, Peter R, Singer, Daniel E, Thomas, Laine, Steinberg, Benjamin A, Peterson, Eric D, Piccini, Jonathan P, and Mahaffey, Kenneth W
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Clinical Research ,Heart Disease ,Cardiovascular ,Age Factors ,Aged ,Aged ,80 and over ,Anti-Arrhythmia Agents ,Anticoagulants ,Atrial Fibrillation ,Female ,Hemorrhage ,Hospitalization ,Humans ,International Normalized Ratio ,Male ,Medication Adherence ,Middle Aged ,Mortality ,Multivariate Analysis ,Patient Reported Outcome Measures ,Patient Satisfaction ,Quality of Health Care ,Stroke ,Time Factors ,Warfarin ,anticoagulation ,atrial fibrillation ,patient-reported outcome ,patient-centered care ,warfarin ,patient‐centered care ,patient‐reported outcome ,Cardiorespiratory Medicine and Haematology - Abstract
Background Patient satisfaction with therapy is an important metric of care quality and has been associated with greater medication persistence. We evaluated the association of patient satisfaction with warfarin therapy to other metrics of anticoagulation care quality and clinical outcomes among patients with atrial fibrillation ( AF ). Methods and Results Using data from the ORBIT - AF (Outcomes Registry for Better Informed Treatment of Atrial Fibrillation) registry, patients were identified with AF who were taking warfarin and had completed an Anti-Clot Treatment Scale ( ACTS ) questionnaire, a validated metric of patient-reported burden and benefit of oral anticoagulation. Multivariate regressions were used to determine association of ACTS burden and benefit scores with time in therapeutic international normalized ratio range ( TTR ; both ≥75% and ≥60%), warfarin discontinuation, and clinical outcomes (death, stroke, major bleed, and all-cause hospitalization). Among 1514 patients with AF on warfarin therapy (75±10 years; 42% women; CHA 2 DS 2- VAS c 3.9±1.7), those most burdened with warfarin therapy were younger and more likely to be women, have paroxysmal AF , and to be treated with antiarrhythmic drugs. After adjustment for covariates, ACTS burden scores were independent of TTR ( TTR ≥75%: odds ratio, 1.01 [95% CI , 0.99-1.03]; TTR ≥60%: odds ratio, 1.01 [95% CI , 0.98-1.05]), warfarin discontinuation (odds ratio, 0.99; 95% CI , 0.97-1.01), or clinical outcomes. ACTS benefit scores were also not associated with TTR , warfarin discontinuation, or clinical outcomes. Conclusions In a large registry of patients with AF taking warfarin, ACTS scores provided independent information beyond other traditional metrics of oral anticoagulation care quality and identified patient groups at high risk for dissatisfaction with warfarin therapy.
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- 2019
35. Ejection fraction, B‐type natriuretic peptide and risk of stroke and acute myocardial infarction among patients with heart failure
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Greenberg, Barry, Peterson, Eric D, Berger, Jeffrey S, Laliberté, François, Zhao, Qi, Germain, Guillaume, Lejeune, Dominique, Wu, Jennifer W, Lefebvre, Patrick, and Fonarow, Gregg C
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Biomedical and Clinical Sciences ,Cardiovascular Medicine and Haematology ,Clinical Research ,Cardiovascular ,Heart Disease ,4.2 Evaluation of markers and technologies ,Detection ,screening and diagnosis ,Aged ,Biomarkers ,Female ,Follow-Up Studies ,Heart Failure ,Hospitalization ,Humans ,Male ,Myocardial Infarction ,Natriuretic Peptide ,Brain ,Prognosis ,Retrospective Studies ,Risk Assessment ,Risk Factors ,Stroke ,Stroke Volume ,United States ,B-type natriuretic peptide ,ejection fraction ,heart failure ,myocardial infarction ,real-world ,stroke ,Cardiorespiratory Medicine and Haematology ,Cardiovascular System & Hematology ,Cardiovascular medicine and haematology - Abstract
BackgroundReal-world data on the clinical outcomes of heart failure (HF) across the spectrum of ejection fraction (EF) and the prognostic value of B-type natriuretic peptide (BNP) have not been well examined.HypothesisThe real-world association between the clinical outcomes of HF and EF or BNP levels may differ across different EF or BNP values.MethodsThe Optum Integrated Claims-Clinical data (07/2009-09/2016) was used to identify adult patients with ≥1 HF diagnosis during hospitalization or emergency room visit. Three EF cohorts were formed: reduced (rEF; EF < 40%), mid-range (mrEF; EF 40%-49%), and preserved EF (pEF; EF ≥ 50%). Stratifications by BNP levels were performed using median BNP as cutoff between high vs low BNP (H-BNP vs L-BNP).ResultsIn total, 7005 HF patients with EF measurements (2456 patients with both HF and BNP measurements) were identified. rEF patients had higher risk of stroke (hazard ratio [HR] = 1.57, P = 0.010) and acute myocardial infarction (AMI) (HR = 2.42, P < 0.001) compared to pEF patients. H-BNP was associated with a significantly higher risk of mortality (P < 0.001). rEF patients with H-BNP had a significantly higher risk of stroke than those with L-BNP.ConclusionsPatients with rEF had a significantly higher rate of stroke and AMI vs pEF patients, as did patients with H-BNP vs L-BNP. The present study is the first to show the real-world association of EF and BNP (alone and in combination) with clinical outcomes, further supporting the recommendation to use these markers in clinical practice. These results may help to guide future recommendations and improve the clinical management of HF.
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- 2019
36. Early therapeutic persistence on dabigatran versus warfarin therapy in patients with atrial fibrillation: results from the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF) registry
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Jackson, Larry R, Kim, Sunghee, Shrader, Peter, Blanco, Rosalia, Thomas, Laine, Ezekowitz, Michael D, Ansell, Jack, Fonarow, Gregg C, Gersh, Bernard J, Go, Alan S, Kowey, Peter R, Mahaffey, Kenneth W, Hylek, Elaine M, Peterson, Eric D, and Piccini, Jonathan P
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Pharmacology and Pharmaceutical Sciences ,Biomedical and Clinical Sciences ,Cardiovascular ,Heart Disease ,Hematology ,Clinical Trials and Supportive Activities ,Clinical Research ,Brain Disorders ,Evaluation of treatments and therapeutic interventions ,6.1 Pharmaceuticals ,Aged ,Anticoagulants ,Atrial Fibrillation ,Dabigatran ,Gastrointestinal Diseases ,Hemorrhage ,Humans ,Patient Compliance ,Registries ,Stroke ,Warfarin ,Atrial fibrillation ,Oral anticoagulation ,Clinical Sciences ,Cardiovascular System & Hematology ,Cardiovascular medicine and haematology ,Clinical sciences - Abstract
Anticoagulation is highly effective for the prevention of stroke in patients with atrial fibrillation (AF) but it is dependent on patients continuing therapy. While studies have demonstrated suboptimal therapeutic persistence on warfarin, few have studied persistence rates with non vitamin K antagonist oral anticoagulants (NOACs) such as dabigatran. We examined rates of continued use of dabigatran versus warfarin over 1 year among AF patients in the ORBIT-AF registry between June 29, 2010 and August 09, 2011. Multivariable logistic regression analysis was used to identify characteristics associated with 1-year persistent use of dabigatran therapy or warfarin. At baseline, 6.4 and 93.6% of 7150 AF patients were on dabigatran and warfarin, respectively. At 12 months, dabigatran-treated patients were less likely to have continued their therapy than warfarin-treated patients [Adjusted persistence rates: 66% (95% CI 60-72) vs. 82% (95% CI 80-84), p
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- 2018
37. Using EHR data to identify coronavirus infections in hospitalized patients: Impact of case definitions on disease surveillance
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Navar, Ann Marie, Cosmatos, Irene, Purinton, Stacey, Ramsey, Janet L., Taylor, Robert J., Sobel, Rachel E., Barlow, Ginger, Dieck, Gretchen S., Bulgrein, Michael L., and Peterson, Eric D.
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- 2022
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38. Secondary Prevention Risk Interventions via Telemedicine and Tailored Patient Education (SPRITE): A randomized trial to improve post myocardial infarction management
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Zullig, Leah L., Peterson, Eric D., Shah, Bimal R., Grambow, Steven C., Oddone, Eugene Z., McCant, Felicia, Lindquist, Jennifer Hoff, and Bosworth, Hayden B.
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- 2022
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39. Guidelines for Cardiovascular Risk Reduction in Patients With Type 2 Diabetes: JACC Guideline Comparison
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Kelsey, Michelle D., Nelson, Adam J., Green, Jennifer B., Granger, Christopher B., Peterson, Eric D., McGuire, Darren K., and Pagidipati, Neha J.
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- 2022
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40. Trends of blood pressure control in the U.S. during the COVID-19 pandemic
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Shah, Nishant P., Clare, Robert M., Chiswell, Karen, Navar, Ann Marie, Shah, Bimal R., and Peterson, Eric D.
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- 2022
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41. The Association of Low Molecular Weight Heparin Use and In-hospital Mortality Among Patients Hospitalized with COVID-19
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Shen, Lan, Qiu, Lin, Liu, Dong, Wang, Li, Huang, Hengye, Ge, Heng, Xiao, Ying, Liu, Yi, Jin, Jingjin, Liu, Xiulan, Wang, Dao Wen, Peterson, Eric D., He, Ben, and Zhou, Ning
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- 2022
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42. Protein biomarkers of cardiac remodeling and inflammation associated with HFpEF and incident events
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Regan, Jessica A., Truby, Lauren K., Tahir, Usman A., Katz, Daniel H., Nguyen, Maggie, Kwee, Lydia Coulter, Deng, Shuliang, Wilson, James G., Mentz, Robert J., Kraus, William E., Hernandez, Adrian F., Gerszten, Robert E., Peterson, Eric D., Holman, Rury R., and Shah, Svati H.
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- 2022
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43. Development and validation of a model to predict cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke in patients with type 2 diabetes mellitus and established atherosclerotic cardiovascular disease
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Stevens, Susanna R., Segar, Matthew W., Pandey, Ambarish, Lokhnygina, Yuliya, Green, Jennifer B., McGuire, Darren K., Standl, Eberhard, Peterson, Eric D., and Holman, Rury R.
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- 2022
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44. Temporal Trends in Post Myocardial Infarction Heart Failure and Outcomes Among Older Adults
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Kochar, Ajar, Doll, Jacob A., Liang, Li, Curran, Jerry, and Peterson, Eric D.
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- 2022
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45. Individual Variation in the Distribution of Apolipoprotein B Levels Across the Spectrum of LDL-C or Non–HDL-C Levels.
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Sayed, Ahmed, Peterson, Eric D., Virani, Salim S., Sniderman, Allan D., and Navar, Ann Marie
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- 2024
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- View/download PDF
46. Risk-Adjusted, 30-Day Home Time After Transcatheter Aortic Valve Replacement as a Hospital-Level Performance Metric
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Mentias, Amgad, Keshvani, Neil, Desai, Milind Y., Kumbhani, Dharam J., Sarrazin, Mary Vaughan, Gao, Yubo, Kapadia, Samir, Peterson, Eric D., Mack, Michael, Girotra, Saket, and Pandey, Ambarish
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- 2022
- Full Text
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47. International Comparison of Patient Characteristics and Quality of Care for Ischemic Stroke: Analysis of the China National Stroke Registry and the American Heart Association Get With The Guidelines––Stroke Program
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Wangqin, Runqi, Laskowitz, Daniel T, Wang, Yongjun, Li, Zixiao, Wang, Yilong, Liu, Liping, Liang, Li, Matsouaka, Roland A, Saver, Jeffrey L, Fonarow, Gregg C, Bhatt, Deepak L, Smith, Eric E, Schwamm, Lee H, Bettger, Janet Prvu, Hernandez, Adrian F, Peterson, Eric D, and Xian, Ying
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Clinical Research ,Stroke ,Brain Disorders ,Neurosciences ,Hematology ,Rehabilitation ,Prevention ,Age Distribution ,Aged ,Brain Ischemia ,China ,Female ,Guideline Adherence ,Humans ,Male ,Middle Aged ,Practice Guidelines as Topic ,Quality Improvement ,Quality of Health Care ,United States ,international comparison ,patient characteristics ,performance measures ,quality of care ,stroke ,Cardiorespiratory Medicine and Haematology - Abstract
Background Adherence to evidence-based guidelines is an important quality indicator; yet, there is lack of assessment of adherence to performance measures in acute ischemic stroke for most world regions. Methods and Results We analyzed 19 604 patients with acute ischemic stroke in the China National Stroke Registry and 194 876 patients in the Get With The Guidelines--Stroke registry in the United States from June 2012 to January 2013. Compared with their US counterparts, Chinese patients were younger, had a lower prevalence of comorbidities, and had similar median, lower mean, and less variability in National Institutes of Health Stroke Scale (median 4 [25th percentile-75th percentile, 2-7], mean 5.4±5.6 versus median 4 [1-10], mean 6.8±7.7). Chinese patients were more likely to experience delays from last known well to hospital arrival (median 1318 [330-3209] versus 644 [142-2055] minutes), less likely to receive thrombolytic therapy (2.5% versus 8.1%), and more likely to experience treatment delays (door-to-needle time median 95 [72-112] versus 62 [49-85] minutes). Adherence to early and discharge antithrombotics, smoking cessation counseling, and dysphagia screening were relatively high (eg >80%) in both countries. Large gaps existed between China and the United States with regard to the administration of thrombolytics within 3 hours (18.3% versus 83.6%), door-to-needle time ≤60 minutes (14.6% versus 48.0%), deep venous thrombosis prophylaxis (65.0% versus 97.8%), anticoagulation for atrial fibrillation (21.0% versus 94.4%), lipid treatment (66.3% versus 95.8%), and rehabilitation assessment (58.8% versus 97.4%). Conclusions We found significant differences in clinical characteristics and gaps in adherence for certain performance measures between China and the United States. Additional efforts are needed for continued improvements in acute stroke care and secondary prevention in both nations, especially China.
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- 2018
48. Pharmacotherapy for Atrial Fibrillation in Patients With Chronic Kidney Disease: Insights From ORBIT‐AF
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Washam, Jeffrey B, Holmes, DaJuanicia N, Thomas, Laine E, Pokorney, Sean D, Hylek, Elaine M, Fonarow, Gregg C, Mahaffey, Kenneth W, Gersh, Bernard J, Kowey, Peter R, Ansell, Jack E, Go, Alan S, Reiffel, James A, Freeman, James V, Singer, Daniel E, Naccarelli, Gerald, Blanco, Rosalia, Peterson, Eric D, and Piccini, Jonathan P
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Clinical Research ,Prevention ,Kidney Disease ,Stroke ,Renal and urogenital ,Cardiovascular ,Good Health and Well Being ,Administration ,Oral ,Aged ,Aged ,80 and over ,Anti-Arrhythmia Agents ,Anticoagulants ,Atrial Fibrillation ,Dabigatran ,Drug Therapy ,Combination ,Female ,Follow-Up Studies ,Humans ,Male ,Middle Aged ,Prospective Studies ,Registries ,Renal Insufficiency ,Chronic ,Risk Factors ,Time Factors ,Treatment Outcome ,Warfarin ,antiarrhythmic ,anticoagulation ,atrial fibrillation ,chronic kidney disease ,Cardiorespiratory Medicine and Haematology - Abstract
Background Chronic kidney disease ( CKD ) is a common comorbidity in patients with atrial fibrillation. The presence of CKD complicates drug selection for stroke prevention and rhythm control. Methods and Results Patients enrolled in ORBIT AF (Outcomes Registry for Better Informed Treatment of Atrial Fibrillation) with baseline renal function and follow-up data were included (N=9019). CKD was defined as an estimated creatinine clearance
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- 2018
49. Intravenous tPA (Tissue-Type Plasminogen Activator) in Patients With Acute Ischemic Stroke Taking Non–Vitamin K Antagonist Oral Anticoagulants Preceding Stroke
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Jin, Chen, Huang, Ryan J, Peterson, Eric D, Laskowitz, Daniel T, Hernandez, Adrian F, Federspiel, Jerome J, Schwamm, Lee H, Bhatt, Deepak L, Smith, Eric E, Fonarow, Gregg C, and Xian, Ying
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Stroke ,Clinical Research ,Neurosciences ,Brain Disorders ,Hematology ,Good Health and Well Being ,Administration ,Intravenous ,Administration ,Oral ,Antibodies ,Monoclonal ,Humanized ,Anticoagulants ,Antidotes ,Antithrombins ,Brain Ischemia ,Dabigatran ,Factor Xa Inhibitors ,Fibrinolytic Agents ,Humans ,Intracranial Hemorrhages ,Odds Ratio ,Practice Guidelines as Topic ,Pyrazoles ,Pyridones ,Rivaroxaban ,Tissue Plasminogen Activator ,apixaban ,dabigatran ,humans ,intracranial hemorrhages ,rivaroxaban ,Cardiorespiratory Medicine and Haematology ,Clinical Sciences ,Neurology & Neurosurgery - Abstract
Background and Purpose- Although there are no trials or large cohorts to inform clinical care, current guidelines caution against giving intravenous tPA (tissue-type plasminogen activator) to patients with acute ischemic stroke who are taking non-vitamin K antagonist oral anticoagulants (NOACs). We performed a literature review of intravenous tPA in patients treated with NOACs preceding stroke. Methods- A literature search of PubMed was performed encompassing January 2010 to March 2018. Patient characteristics, timing of last medication intake, laboratory testing, use of reversal, and outcomes ≤3 months after discharge were summarized. Results- We identified 55 studies with 492 NOAC patients receiving tPA (dabigatran, 181; rivaroxaban, 215; apixaban, 40; and unspecified NOAC, 56). Among patients with complete data, the median time from the last NOAC intake to symptom onset was 8 hours (interquartile range, 2.5-14.5), with 55.2% (80/145) within 12 hours. Few patients underwent sensitive laboratory tests, such as thrombin time, diluted thrombin time, or anti-Xa assays before tPA administration. The overall observed rates of symptomatic intracranial hemorrhage, mortality, and favorable outcomes (National Institutes of Health Stroke Scale score, ≤1; modified Rankin Scale score, 0-2; or neurological improvement in the National Institutes of Health Stroke Scale score, ≥8 points) were 4.3% (20/462), 11.3% (48/423), and 43.7% (164/375), respectively. Among dabigatran-treated patients, reversal with idarucizumab was associated with fewer symptomatic intracranial hemorrhage (4.5% [2/44] versus 7.4% [8/108]; unadjusted odds ratio, 0.60; 95% CI, 0.12-2.92), death (4.5% [2/44] versus 12.0% [13/108]; unadjusted odds ratio, 0.35; 95% CI, 0.08-1.61), and more favorable outcomes (79.1% [34/43] versus 39.2% [29/74]; unadjusted odds ratio, 5.86; 95% CI, 2.45-14.00), although the differences were not statistically significant for symptomatic intracranial hemorrhage and death. Conclusions- These preliminary observations suggest that tPA may be reasonably well tolerated without prohibitive risks of bleeding complications in selected patients on NOACs. Reversal of anticoagulant effects by idarucizumab for dabigatran-treated patients before tPA is an emerging strategy that was associated with more favorable outcomes.
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- 2018
50. Stroke Risk and Treatment in Patients with Atrial Fibrillation and Low CHA2DS2‐VASc Scores: Findings From the ORBIT‐AF I and II Registries
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JacksonII, Larry R, Kim, Sunghee, Fonarow, Gregg C, Freeman, James V, Gersh, Bernard J, Go, Alan S, Hylek, Elaine M, Kowey, Peter R, Mahaffey, Kenneth W, Singer, Daniel, Thomas, Laine, Blanco, Rosalia, Peterson, Eric D, PicciniSr, Jonathan P, and Patients and Investigators, the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation
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Stroke ,Brain Disorders ,Cardiovascular ,Intellectual and Developmental Disabilities (IDD) ,Good Health and Well Being ,Aged ,Aged ,80 and over ,Anticoagulants ,Atrial Fibrillation ,Case-Control Studies ,Female ,Humans ,Ischemic Attack ,Transient ,Male ,Middle Aged ,Mortality ,Platelet Aggregation Inhibitors ,Registries ,Risk Assessment ,Sex Factors ,oral anticoagulation ,Outcomes Registry for Better Informed Treatment of Atrial Fibrillation ,stroke ,Outcomes Registry for Better Informed Treatment of Atrial Fibrillation Patients and Investigators ,Cardiorespiratory Medicine and Haematology - Abstract
Background Current American College of Cardiology/American Heart Association guidelines suggest that for patients with atrial fibrillation who are at low risk for stroke (CHA2DS2VASc=1) (or women with CHA2DS2VASc=2) a variety of treatment strategies may be considered. However, in clinical practice, patterns of treatment in these "low-risk" patients are not well described. The objective of this analysis is to define thromboembolic event rates and to describe treatment patterns in patients with low-risk CHA2DS2VASc scores. Methods and Results We compared characteristics, treatment strategies, and outcomes among patients with a CHA2DS2VASc=0, CHA2DS2VASc=1, females with a CHA2DS2VASc=2, and CHA2DS2VASc ≥2 in ORBIT-AF (Outcomes Registry for Better Informed Treatment of Atrial Fibrillation) I & II. Compared with CHA2DS2VASc ≥2 patients (84.2%), those with a CHA2DS2VASc=0 (60.3%), 1 (69.9%), and females with a CHA2DS2VASc score=2 (72.4%) were significantly less often treated with oral anticoagulation ( P
- Published
- 2018
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