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https://www.readbyqxmd.com/read/29141842/treatment-of-atrial-fibrillation-and-concordance-with-the-american-heart-association-american-college-of-cardiology-heart-rhythm-society-guidelines-findings-from-orbit-af-outcomes-registry-for-better-informed-treatment-of-atrial-fibrillation
#1
Adam S Barnett, Sunghee Kim, Gregg C Fonarow, Laine E Thomas, James A Reiffel, Larry A Allen, James V Freeman, Gerald Naccarelli, Kenneth W Mahaffey, Alan S Go, Peter R Kowey, Jack E Ansell, Bernard J Gersh, Elaine M Hylek, Eric D Peterson, Jonathan P Piccini
BACKGROUND: It is unclear how frequently patients with atrial fibrillation receive guideline-concordant (GC) care and whether guideline concordance is associated with improved outcomes. METHODS AND RESULTS: Using data from ORBIT-AF (Outcomes Registry for Better Informed Treatment of Atrial Fibrillation), we determined how frequently patients received care that was concordant with 11 recommendations from the 2014 American Heart Association/American College of Cardiology/Heart Rhythm Society atrial fibrillation guidelines pertaining to antithrombotic therapy, rate control, and antiarrhythmic medications...
November 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/29128866/association-of-atrial-fibrillation-clinical-phenotypes-with-treatment-patterns-and-outcomes-a-multicenter-registry-study
#2
Taku Inohara, Peter Shrader, Karen Pieper, Rosalia G Blanco, Laine Thomas, Daniel E Singer, James V Freeman, Larry A Allen, Gregg C Fonarow, Bernard Gersh, Michael D Ezekowitz, Peter R Kowey, James A Reiffel, Gerald V Naccarelli, Paul S Chan, Benjamin A Steinberg, Eric D Peterson, Jonathan P Piccini
Importance: Atrial fibrillation (AF) is usually classified on the basis of the disease subtype. However, this characterization does not capture the full heterogeneity of AF, and a data-driven cluster analysis reveals different possible classifications of patients. Objective: To characterize patients with AF based on a cluster analysis and to evaluate the association between these phenotypes, treatment, and clinical outcomes. Design, Setting, and Participants: This cluster analysis used data from an observational cohort that included 9749 patients with AF who had been admitted to 174 US sites participating in the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF) registry...
November 12, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/29122636/clinical-outcomes-and-history-of-fall-in-patients-with-atrial-fibrillation-treated-with-oral-anticoagulation-insights-from-the-aristotle-trial
#3
Meena P Rao, Dragos Vinereanu, Daniel M Wojdyla, John H Alexander, Dan Atar, Elaine M Hylek, Michael Hanna, Lars Wallentin, Renato D Lopes, Bernard J Gersh, Christopher B Granger
PURPOSE: We assessed outcomes among anticoagulated patients with atrial fibrillation (AF) and a history of falling, and whether the benefits of apixaban versus warfarin are consistent in this population. METHODS: Of the 18,201 patients in ARISTOTLE, 16,491 had information about history of falling - 753 with history of falling and 15,738 without history of falling. The primary efficacy outcome was stroke or systemic embolism; the primary safety outcome was major bleeding...
November 6, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/29089455/echocardiographic-risk-factors-for-stroke-and-outcomes-in-patients-with-atrial-fibrillation-anticoagulated-with-apixaban-or-warfarin
#4
Dragos Vinereanu, Renato D Lopes, Hillary Mulder, Bernard J Gersh, Michael Hanna, Pedro G M de Barros E Silva, Dan Atar, Lars Wallentin, Christopher B Granger, John H Alexander
BACKGROUND AND PURPOSE: Few data exist on the long-term outcomes of patients with spontaneous echo contrast (SEC), left atrial/left atrial appendage (LA/LAA) thrombus, and complex aortic plaque (CAP), in patients with atrial fibrillation receiving oral anticoagulation. We explored the relationship between these 3 echocardiographic findings and clinical outcomes, and the comparative efficacy and safety of apixaban and warfarin for each finding. METHODS: Patients from the ARISTOTLE trial (Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation) with SEC, LA/LAA thrombus, or CAP diagnosed by either transthoracic or transesophageal echocardiography were compared with patients with none of these findings on transesophageal echocardiography...
October 31, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29044400/erratum
#5
Keith A A Fox, Bernard J Gersh, Sory Traore, A John Camm, Gloria Kayani, Anders Krogh, Shweta Shweta, Ajay K Kakkar
No abstract text is available yet for this article.
October 1, 2017: European Heart Journal. Quality of Care & Clinical Outcomes
https://www.readbyqxmd.com/read/29030143/impact-of-atrial-fibrillation-on-outcomes-with-motor-vehicle-accidents
#6
Kanishk Agnihotri, N V Pothineni, Paris Charilaou, Vaibhav R Vaidya, Badal Thakkar, Vishal Goyal, Sabeeda Kadavath, Nileshkumar Patel, Apurva Badheka, Peter Noseworthy, Suraj Kapa, Paul Friedman, Bernard Gersh, Hakan Paydak, Abhishek Deshmukh
BACKGROUND: We examined the effect of AF a commonly encountered arrhythmia with significant morbidity on mortality following a motor vehicle accident (MVA) related hospitalization. METHODS: The Nationwide Inpatient Sample (NIS) was queried to identify patients with AF (ICD-9 CM 427.31) and MVA (ICD-9 CM E810.0-E819.9), considered separately and together, from 2003 through 2012. Baseline characteristics were identified and multilevel mixed model multivariate analysis was employed to verify the impact of AF on in-patient mortality in survivors...
October 3, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/29028610/systematic-review-and-meta-analysis-of-dropout-rates-in-individual-psychotherapy-for-generalized-anxiety-disorder
#7
REVIEW
Elon Gersh, David J Hallford, Simon M Rice, Nikolaos Kazantzis, Hannah Gersh, Benji Gersh, Carolyn A McCarty
BACKGROUND: Despite being a relatively prevalent and debilitating disorder, Generalized Anxiety Disorder (GAD) is the second least studied anxiety disorder and among the most difficult to treat. Dropout from psychotherapy is concerning as it is associated with poorer outcomes, leads to service inefficiencies and can disproportionately affect disadvantaged populations. No study to date has calculated a weighted mean dropout rate for GAD and explored associated correlates. METHODS: A systematic review was conducted using PsycINFO, Medline and Embase databases, identifying studies investigating individual psychotherapies for adults with GAD...
October 6, 2017: Journal of Anxiety Disorders
https://www.readbyqxmd.com/read/29020402/women-with-hypertrophic-cardiomyopathy-have-worse-survival
#8
Jeffrey B Geske, Kevin C Ong, Konstantinos C Siontis, Virginia B Hebl, Michael J Ackerman, David O Hodge, Virginia M Miller, Rick A Nishimura, Jae K Oh, Hartzell V Schaff, Bernard J Gersh, Steve R Ommen
Aims: Sex differences in hypertrophic cardiomyopathy (HCM) remain unclear. We sought to characterize sex differences in a large HCM referral centre population. Methods and results: Three thousand six hundred and seventy-three adult patients with HCM underwent evaluation between January 1975 and September 2012 with 1661 (45.2%) female. Kaplan-Meier survival curves were assessed via log-rank test. Cox proportional hazard regression analyses evaluated the relation of sex with survival...
September 8, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29020347/transcatheter-aortic-valve-implantation-in-lower-risk-patients-what-is-the-perspective
#9
Giuseppe Tarantini, Luca Nai Fovino, Bernard J Gersh
In the last decade, transcatheter aortic valve implantation (TAVI), a disruptive technology, has revolutionized the therapy of symptomatic severe aortic stenosis, and current guidelines state that the recommendations for TAVI and surgical aortic valve replacement (SAVR) are equivalent in patients at high-risk. Increased operator experience, technical advances in the new generation of transcatheter heart valves (THV) and excellent TAVI results in recently published randomized controlled trials have led to the expansion of TAVI indication as an alternative to SAVR in intermediate-risk subjects, given appropriate patient selection...
August 24, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28985078/kinetics-of-supersaturated-solution-with-restricted-size-of-precipitates-in-the-presence-of-dimer-adsorption-emission-and-monomer-monomer-agglomeration
#10
Gersh O Berim, Lana I Brim, Eli Ruckenstein
Kinetics of supersaturated solutions with restricted size of precipitating particles is considered using the microscopic theory which includes monomer-monomer agglomeration (MMA) and dimer adsorption/emission (DAE). It is shown that the system passes, during its evolution from initial to final state, through four consecutive stages. In stage I and stage III, the scaled size distribution of particles changes quickly with increasing time while in stage II and stage IV it is almost independent of time. It is argued that during stage II the system, at any rates of MMA and DAE, is in a regime similar to the asymptotic regime provided by the classical Lifshitz-Slyouzov-Wagner (LSW) theory where no restrictions on the size of the particles are imposed and MMA and DAE are not considered...
October 20, 2017: Journal of Physical Chemistry. B
https://www.readbyqxmd.com/read/28938965/impact-of-atrial-fibrillation-on-outcomes-of-patients-treated-by-transcatheter-aortic-valve-implantation-a-systematic-review-and-meta-analysis
#11
REVIEW
Marco Mojoli, Bernard J Gersh, Alberto Barioli, Giulia Masiero, Paola Tellaroli, Gianpiero D'Amico, Giuseppe Tarantini
BACKGROUND: Conflicting data have been reported related to the impact of atrial fibrillation (AF) on the outcomes after transcatheter aortic valve implantation (TAVI). We aimed to assess the prognosis of TAVI-treated patients according to the presence of pre-existing or new-onset AF. METHODS: Studies published between April 2002 and November 2016 and reporting outcomes of pre-existing AF, new-onset AF, or sinus rhythm in patients undergoing TAVI were identified with an electronic search...
October 2017: American Heart Journal
https://www.readbyqxmd.com/read/28927171/evolving-quality-standards-for-large-scale-registries-the-garfield-af-experience
#12
Keith A A Fox, Bernard J Gersh, Sory Traore, A John Camm, Gloria Kayani, Anders Krogh, Shweta Shweta, Ajay K Kakkar
Aims: Registries have the potential to capture treatment practices and outcomes in populations beyond the constraints of clinical trial settings. The value of data obtained depend critically upon robust quality standards (including source data verification [SDV] and training); features that are commonly absent from registries. This article outlines the quality standards developed for Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF). Methods and Results: GARFIELD-AF comprises ∼57 000 patients prospectively recruited over 6...
April 1, 2017: European Heart Journal. Quality of Care & Clinical Outcomes
https://www.readbyqxmd.com/read/28919378/sudden-death-mechanisms-in-nonischemic-cardiomyopathies-insights-gleaned-from-clinical-implantable-cardioverter-defibrillator-trials
#13
Benjamin A Steinberg, Siva K Mulpuru, James C Fang, Bernard J Gersh
Sudden cardiac death (SCD) represents a major cause of death among patients with heart failure. Although scar-based, macroreentrant ventricular tachycardia/ventricular fibrillation is the primary etiology for SCD among patients with ischemic cardiomyopathy, a more diverse set of mechanisms and substrates is likely at play for the diverse group of patients characterized by nonischemic dilated cardiomyopathy (NICM). These causes may include scar-based reentry, but also neurohormonal stimulation (sympathetic, parasympathetic, renin-angiotensin-aldosterone), inflammation, and nonarrhythmic processes occurring in the context of a genetic predisposition...
September 23, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28882229/care-patterns-and-outcomes-in-atrial%C3%A2-fibrillation-patients-with-and-without-diabetes-orbit-af-registry
#14
MULTICENTER STUDY
Justin B Echouffo-Tcheugui, Peter Shrader, Laine Thomas, Bernard J Gersh, Peter R Kowey, Kenneth W Mahaffey, Daniel E Singer, Elaine M Hylek, Alan S Go, Eric D Peterson, Jonathan P Piccini, Gregg C Fonarow
BACKGROUND: Diabetes is a well-established risk factor for thromboembolism in patients with atrial fibrillation (AF), but less is known about how diabetes influences outcomes among AF patients. OBJECTIVES: This study assessed whether symptoms, health status, care, and outcomes differ between AF patients with and without diabetes. METHODS: The cohort study included 9,749 patients from the ORBIT-AF (Outcomes Registry for Better Informed Treatment of Atrial Fibrillation) registry, a prospective, nationwide, outpatient registry of patients with incident and prevalent AF...
September 12, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28870652/adolescent-health-risk-behaviors-parental-concern-and-concordance-between-parent-and-adolescent-reports
#15
Elon Gersh, Laura P Richardson, Katherine Katzman, Heather Spielvogle, Adriana Cristina Arghira, Chuan Zhou, Carolyn A McCarty
OBJECTIVE: We investigated which adolescent health risk behaviors are of concern to parents generally, according to adolescent age, gender, and in the context of perceived risk. We compared adolescent and parent reports of the presence of health-risk behaviors and factors predicting agreement. METHODS: Three hundred adolescents aged 13 to 18 years (mean, 14.5 years; 52% female) who presenting for well care completed an electronic screening tool used to assess health-risk behaviors...
September 1, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/28861455/baseline-characteristics-and-event-rates-among-anticoagulated-patients-with-atrial-fibrillation-in-practice-and-pivotal-noac-trials
#16
Peter A Noseworthy, Xiaoxi Yao, Bernard J Gersh, Ian Hargraves, Nilay D Shah, Victor M Montori
The data report details the baseline characteristics and observed outcomes among patients included in a large US administrative claims database (Optum Labs Data Warehouse) and those enrolled in the pivotal phase III clinical trials examining apixaban, dabigratan, edoxaban and rivaroxaban versus warfarin for the prevention of cardio embolism (Granger et al., 2011; Cannolly et al., 2009; Patel et al., 2011; Giugliano et al., 2013) [1], [2], [3], [4]. These data are to be interpreted in the context of the linked publication (Noseworthy et al...
October 2017: Data in Brief
https://www.readbyqxmd.com/read/28844514/comparison-of-the-cha2ds2-vasc-chads2-has-bled-orbit-and-atria-risk-scores-in-predicting-non-vitamin-k-antagonist-oral-anticoagulants-associated-bleeding-in-patients-with-atrial-fibrillation
#17
COMPARATIVE STUDY
Xiaoxi Yao, Bernard J Gersh, Lindsey R Sangaralingham, David M Kent, Nilay D Shah, Neena S Abraham, Peter A Noseworthy
The increasing adoption of non-vitamin K antagonist oral anticoagulants (NOACs) for stroke prevention in atrial fibrillation (AF) necessitates a reassessment of bleeding risk scores. Because known risk factors for bleeding are largely the same as for stroke, we hypothesize that stroke risk scores could also be used to identify patients with high bleeding risks. We aimed to compare the performance of 2 stroke risk scores (Congestive Heart failure, hypertension, Age ≥75 [doubled], Diabetes, Stroke [doubled], Vascular disease, Age 65-74, and Sex [female] [CHA2DS2-VASc] and Cardiac failure, Hypertension, Age, Diabetes, Stroke [Doubled] [CHADS2]) and 3 bleeding risk scores (hypertension, abnormal renal/liver function [1 point each], stroke, bleeding history or predisposition, labile INR, elderly [...
November 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28844035/state-of-the-art-optimal-medical-therapy-competing-with-or-complementary-to-revascularisation-in-patients-with-coronary-artery-disease
#18
Javaid Iqbal, Robert Widmer, Bernard J Gersh
The role of coronary revascularisation with PCI and CABG in patients with stable and unstable coronary artery disease (CAD) is well established and there is a general consensus among guidelines as regards the indications for coronary revascularisation. Although revascularisation has undoubtedly revolutionised the treatment of CAD, it is vital to understand the recent advances and importance of the concomitant use of evidence-based optimal medical therapy (OMT). In contemporary practice, OMT should include an antiplatelet agent (or dual antiplatelet therapy when indicated) and a lipid-lowering drug for all patients, and a beta-blocker and an ACE inhibitor (or angiotensin receptor blocker) for the vast majority of patients, along with addressing cardiac risk factors and lifestyle management...
August 25, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28842973/incidence-of-previously-undiagnosed-atrial-fibrillation-using-insertable-cardiac-monitors-in-a-high-risk-population-the-reveal-af-study
#19
James A Reiffel, Atul Verma, Peter R Kowey, Jonathan L Halperin, Bernard J Gersh, Rolf Wachter, Erika Pouliot, Paul D Ziegler
Importance: In approximately 20% of atrial fibrillation (AF)-related ischemic strokes, stroke is the first clinical manifestation of AF. Strategies are needed to identify and therapeutically address previously undetected AF. Objective: To quantify the incidence of AF in patients at high risk for but without previously known AF using an insertable cardiac monitor. Design, Setting, and Participants: This prospective, single-arm, multicenter study was conducted from November 2012 to January 2017...
October 1, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28838088/management-and-outcomes-of-patients-with-atrial-fibrillation-and-a-history-of-cancer-the-orbit-af-registry
#20
Chiara Melloni, Peter Shrader, Joseph Carver, Jonathan P Piccini, Laine Thomas, Gregg C Fonarow, Jack Ansell, Bernard Gersh, Alan S Go, Elaine Hylek, Irving M Herling, Kenneth W Mahaffey, Anthony F Yu, Eric D Peterson, Peter R Kowey
Aims: The presence of cancer can complicate treatment choices for patients with atrial fibrillation (AF) increasing both the risk of thrombotic and bleeding events. Methods and results: Using data from Outcomes Registry for Better Informed Treatment of Atrial Fibrillation, we aimed to characterize AF patients with cancer, to describe their management and to assess the association between cancer and cardiovascular (CV) outcomes. Among 9749 patients, 23.8% had history of cancer (57% solid malignancy, 1...
July 1, 2017: European Heart Journal. Quality of Care & Clinical Outcomes
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