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https://www.readbyqxmd.com/read/28927171/evolving-quality-standards-for-large-scale-registries-the-garfield-af-experience
#1
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-non-ischemic-cardiomyopathies-insights-gleaned-from-clinical-implantable-cardioverter-defibrillator-trials
#2
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. While scar-based, macro-reentrant ventricular tachycardia and ventricular fibrillation (VT/VF) is the primary etiology for SCD among patients with ischemic cardiomyopathy, a more diverse set of mechanisms and substrates are likely at play for the diverse group of patients characterized by non-ischemic, dilated cardiomyopathy (NICM). These causes may include scar-based re-entry, but also neurohormonal stimulation (sympathetic, parasympathetic, renin-angiotensin-aldosterone), inflammation, and non-arrhythmic processes occurring in the context of a genetic predisposition...
September 14, 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
#3
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
#4
Elon Gersh, Laura P Richardson, Katherine Katzman, Heather Spielvogle, Adriana Arghira, Chuan Zhou, Carolyn A McCarty
OBJECTIVE: Investigated which adolescent health-risk behaviors are of concern to parents generally, according to adolescent age, gender, and in the context of perceived risk. Compared adolescent and parent reports of the presence of health-risk behaviors and factors predicting agreement. METHODS: 300 adolescents aged 13-18 (M=14.5, 52% female) presenting for well care completed an electronic screening tool assessing health-risk behaviors. Parents completed parallel measures of their child's behavior and parental concern...
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
#5
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
#6
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 [...
July 31, 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
#7
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
#8
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...
August 26, 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
#9
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
https://www.readbyqxmd.com/read/28835363/the-metabolic-syndrome-and-risk-of-sudden-cardiac-death-the-atherosclerosis-risk-in-communities-study
#10
Paul L Hess, Hussein R Al-Khalidi, Daniel J Friedman, Hillary Mulder, Anna Kucharska-Newton, Wayne R Rosamond, Renato D Lopes, Bernard J Gersh, Daniel B Mark, Lesley H Curtis, Wendy S Post, Ronald J Prineas, Nona Sotoodehnia, Sana M Al-Khatib
BACKGROUND: Prior studies have demonstrated a link between the metabolic syndrome and increased risk of cardiovascular mortality. Whether the metabolic syndrome is associated with sudden cardiac death is uncertain. METHODS AND RESULTS: We characterized the relationship between sudden cardiac death and metabolic syndrome status among participants of the ARIC (Atherosclerosis Risk in Communities) Study (1987-2012) free of prevalent coronary heart disease or heart failure...
August 23, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28790169/disease-understanding-in-patients-newly-diagnosed-with-atrial-fibrillation
#11
Brystana G Kaufman, Sunghee Kim, Karen Pieper, Larry A Allen, Bernard J Gersh, Gerald V Naccarelli, Michael D Ezekowitz, Gregg C Fonarow, Kenneth W Mahaffey, Daniel E Singer, Paul S Chan, James V Freeman, Jack Ansell, Peter R Kowey, James A Rieffel, Jonathan Piccini, Eric Peterson, Emily C O'Brien
OBJECTIVE: To describe self-reported disease understanding for newly diagnosed patients with atrial fibrillation (AF) and assess (1) how disease understanding changes over the first 6 months after diagnosis and (2) the relationship between patient understanding of therapies at baseline and treatment receipt at 6 months among treatment-naïve patients. METHODS: We analysed survey data from SATELLITE (Survey of Patient Knowledge and Personal Priorities for Treatment), a substudy of patients with new-onset AF enrolled in the national Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT) II registry across 56 US sites...
August 8, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28739198/efficacy-and-safety-of-apixaban-versus-warfarin-in-patients-with-atrial-fibrillation-and-a-history-of-cancer-insights-from-the-aristotle-trial
#12
Chiara Melloni, Allison Dunning, Christopher B Granger, Laine Thomas, Michel G Khouri, David A Garcia, Elaine M Hylek, Michael Hanna, Lars Wallentin, Bernard J Gersh, Pamela S Douglas, John H Alexander, Renato D Lopes
BACKGROUND: Cancer is associated with a prothrombotic state and increases the risk of thrombotic events in patients with atrial fibrillation. We described the clinical characteristics and outcomes and assessed the safety and efficacy of apixaban versus warfarin in patients with atrial fibrillation and cancer in the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE) trial. METHODS: The association between cancer and clinical outcomes was assessed using Cox regression models...
July 21, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28733071/long-term-stroke-and-bleeding-risk-in-patients-with-atrial-fibrillation-treated-with-oral-anticoagulants-in-contemporary-practice-providing-evidence-for-shared-decision-making
#13
Peter A Noseworthy, Xiaoxi Yao, Bernard J Gersh, Ian Hargraves, Nilay D Shah, Victor M Montori
BACKGROUND: Oral anticoagulation is recommended as a lifelong therapy for most patients with atrial fibrillation (AF). However, data on long-term outcomes in clinical practice on these drugs are scarce, particularly for the recently approved agents. We aimed to describe differences in characteristics between patients in everyday practice and those enrolled in the pivotal trials, and to report long-term outcomes on oral anticoagulation in practice. METHODS: We performed a retrospective cohort analysis using a large U...
July 14, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28696573/prognostic-implications-of-q-waves-at-presentation-in-patients-with-st-segment-elevation-myocardial-infarction-undergoing-primary-percutaneous-coronary-intervention-an-analysis-of-the-horizons-ami-study
#14
Ioanna Kosmidou, Björn Redfors, Aaron Crowley, Bernard Gersh, Shmuel Chen, José M Dizon, Monica Embacher, Roxana Mehran, Ori Ben-Yehuda, Gary S Mintz, Gregg W Stone
BACKGROUND: Presence of Q waves on the presenting electrocardiogram (ECG) in patients with ST-segment elevation myocardial infarction (STEMI) has been associated with worse prognosis; however, whether the prognostic value of Q waves is influenced by baseline characteristics and/or rapidity of revascularization based on the guideline-based metric of door-to-balloon time remains unknown. HYPOTHESIS: We hypothesized that Q waves in the presenting ECG will be predictive of long term mortality regardless of time to reperfusion...
July 11, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28645934/repeated-measurements-of-cardiac-biomarkers-in-atrial-fibrillation-and-validation-of-the-abc-stroke-score-over-time
#15
Ziad Hijazi, Bertil Lindahl, Jonas Oldgren, Ulrika Andersson, Johan Lindbäck, Christopher B Granger, John H Alexander, Bernard J Gersh, Michael Hanna, Veli-Pekka Harjola, Elaine M Hylek, Renato D Lopes, Agneta Siegbahn, Lars Wallentin
BACKGROUND: Cardiac biomarkers are independent risk markers in atrial fibrillation, and the novel biomarker-based ABC stroke score (age, biomarkers, and clinical history of prior stroke) was recently shown to improve the prediction of stroke risk in patients with atrial fibrillation. Our aim was to investigate the short-term variability of the cardiac biomarkers and evaluate whether the ABC stroke risk score provides a stable short-term risk estimate. METHODS AND RESULTS: According to the study protocol, samples were obtained at entry and also at 2 months in 4796 patients with atrial fibrillation followed for a median of 1...
June 23, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28625380/factors-associated-with-non-vitamin-k-antagonist-oral-anticoagulants-for-stroke-prevention-in-patients-with-new-onset-atrial-fibrillation-results-from-the-outcomes-registry-for-better-informed-treatment-of-atrial-fibrillation-ii-orbit-af-ii
#16
MULTICENTER STUDY
Benjamin A Steinberg, Peter Shrader, Laine Thomas, Jack Ansell, Gregg C Fonarow, Bernard J Gersh, Elaine Hylek, Peter R Kowey, Kenneth W Mahaffey, Emily C O'Brien, Daniel E Singer, Eric D Peterson, Jonathan P Piccini
BACKGROUND: Several non-vitamin K antagonist oral anticoagulant (NOAC) alternatives to warfarin are available for stroke prevention in atrial fibrillation (AF). We aimed to describe the factors associated with selection of NOACs versus warfarin in patients with new onset AF. METHODS: The ORBIT-AF II study is a national, US, prospective, observational, cohort study of anticoagulation treatment in patients with AF receiving NOACs or warfarin in the United States from 2013 to 2016...
July 2017: American Heart Journal
https://www.readbyqxmd.com/read/28595692/non-vitamin-k-antagonist-oral-anticoagulant-dosing-in-patients-with-atrial-fibrillation-and-renal-dysfunction
#17
MULTICENTER STUDY
Xiaoxi Yao, Nilay D Shah, Lindsey R Sangaralingham, Bernard J Gersh, Peter A Noseworthy
BACKGROUND: Dose reduction of non-vitamin K antagonist oral anticoagulants (NOACs) is indicated in patients with atrial fibrillation (AF) with renal impairment. Failure to reduce the dose in patients with severe kidney disease may increase bleeding risk, whereas dose reductions without a firm indication may decrease the effectiveness of stroke prevention. OBJECTIVES: The goal of this study was to investigate NOAC dosing patterns and associated outcomes, i.e., stroke (ischemic stroke and systemic embolism) and major bleeding in patients treated in routine clinical practice...
June 13, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28560782/benefit-of-cardiopoietic-mesenchymal-stem-cell-therapy-on-left-ventricular-remodelling-results-from-the-congestive-heart-failure-cardiopoietic-regenerative-therapy-chart-1-study
#18
John R Teerlink, Marco Metra, Gerasimos S Filippatos, Beth A Davison, Jozef Bartunek, Andre Terzic, Bernard J Gersh, Thomas J Povsic, Timothy D Henry, Bertrand Alexandre, Christian Homsy, Christopher Edwards, Aymeric Seron, William Wijns, Gad Cotter
AIMS: Left ventricular (LV) reverse remodelling is an important marker of improved outcomes in patients with advanced heart failure (HF). We examined the impact of the intramyocardial administration of bone-marrow-derived, lineage-directed, autologous cardiopoietic mesenchymal stem cells (C3BS-CQR-1) on LV remodelling in patients with advanced HF enrolled in the CHART-1 study. METHODS AND RESULTS: Patients (n=351) with symptomatic advanced HF secondary to ischaemic heart disease, and reduced LV ejection fraction (LVEF <35%) were randomized to receive C3BS-CQR-1 or a sham procedure...
May 31, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28543401/oral-anticoagulation-management-in-patients-with-atrial-fibrillation-undergoing-cardiac-implantable-electronic-device-implantation
#19
Eric Black-Maier, Sunghee Kim, Benjamin A Steinberg, Gregg C Fonarow, James V Freeman, Peter R Kowey, Jack Ansell, Bernard J Gersh, Kenneth W Mahaffey, Gerald Naccarelli, Elaine M Hylek, Alan S Go, Eric D Peterson, Jonathan P Piccini
BACKGROUND: Oral anticoagulation (OAC) therapy is associated with increased periprocedural risks after cardiac implantable electronic device (CIED) implantation. Patterns of anticoagulation management involving non-vitamin K antagonist oral anticoagulants (NOACs) have not been characterized. HYPOTHESIS: Anticoagulation strategies and outcomes differ by anticoagulant type in patients undergoing CIED implantation. METHODS: Using the nationwide Outcomes Registry for Better Informed Treatment of Atrial Fibrillation, we assessed how atrial fibrillation (AF) patients undergoing CIED implantation were cared for and their subsequent outcomes...
May 19, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28491749/recurrent-flash-pulmonary-edema-due-to-rate-dependent-left-bundle-branch-block
#20
Nicholas Y Tan, Chance M Witt, Christopher J McLeod, Bernard J Gersh
No abstract text is available yet for this article.
November 2016: HeartRhythm Case Reports
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