2023
DAPT Is Comparable to OAC Following LAAC With WATCHMAN FLX A National Registry Analysis
Coylewright M, Holmes D, Kapadia S, Hsu J, Gibson D, Freeman J, Yeh R, Piccini J, Price M, Allocco D, Nair D. DAPT Is Comparable to OAC Following LAAC With WATCHMAN FLX A National Registry Analysis. JACC Cardiovascular Interventions 2023, 16: 2708-2718. PMID: 37943200, DOI: 10.1016/j.jcin.2023.08.013.Peer-Reviewed Original ResearchConceptsDual antiplatelet therapyDevice-related thrombusOral anticoagulationWatchman FLXStroke preventionLong-term oral anticoagulationComposite endpoint rateMedical therapy optionsNational registry analysisSimilar safety profilePropensity-matched analysisAtrial appendage occlusionAspirin patientsDAPT patientsMajor bleedingAntiplatelet therapyComposite endpointDrug regimensMedication regimensAppendage occlusionComorbid conditionsAtrial fibrillationRegistry analysisSafety profileMean age
2022
Left Atrial Appendage Occlusion Versus Oral Anticoagulation in Atrial Fibrillation : A Decision Analysis.
Chew DS, Zhou K, Pokorney SD, Matchar DB, Vemulapalli S, Allen LA, Jackson KP, Samad Z, Patel MR, Freeman JV, Piccini JP. Left Atrial Appendage Occlusion Versus Oral Anticoagulation in Atrial Fibrillation : A Decision Analysis. Annals Of Internal Medicine 2022, 175: 1230-1239. PMID: 35969865, DOI: 10.7326/m21-4653.Peer-Reviewed Original ResearchConceptsDirect oral anticoagulantsHigh bleeding riskLower stroke riskClinical effectiveness dataAtrial fibrillationBleeding riskStroke riskOral anticoagulantsIschemic strokeEffectiveness dataHAS-BLED scoreIndividual riskHigh stroke riskMajor bleeding riskNonvalvular atrial fibrillationPatient's individual riskPrimary end pointAtrial appendage occlusionBase-case analysisOral anticoagulationPrior strokeVASc scoreStroke preventionWatchman deviceAppendage occlusionAntithrombotic Therapy After Left Atrial Appendage Occlusion in Patients With Atrial Fibrillation
Freeman JV, Higgins AY, Wang Y, Du C, Friedman DJ, Daimee UA, Minges KE, Pereira L, Goldsweig AM, Price MJ, Reddy VY, Gibson D, Doshi SK, Varosy PD, Masoudi FA, Curtis JP. Antithrombotic Therapy After Left Atrial Appendage Occlusion in Patients With Atrial Fibrillation. Journal Of The American College Of Cardiology 2022, 79: 1785-1798. PMID: 35512858, PMCID: PMC9097170, DOI: 10.1016/j.jacc.2022.02.047.Peer-Reviewed Original ResearchConceptsLeft atrial appendage occlusionAdverse eventsPivotal trialsWatchman deviceTreatment protocolAntithrombotic strategiesAppendage occlusionLower riskFrailty regressionPercutaneous left atrial appendage occlusionNational Cardiovascular Data RegistryContemporary U.S. practiceDual antiplatelet therapyAtrial appendage occlusionConcomitant aspirinPostprocedure careAdjusted riskAntiplatelet therapyAntithrombotic medicationAntithrombotic therapyAtrial fibrillationAdverse outcomesTrial protocolAntithrombotic agentsMedication strategiesPatient-Level Analysis of Watchman Left Atrial Appendage Occlusion in Practice Versus Clinical Trials
Friedman DJ, Du C, Wang Y, Agarwal V, Varosy PD, Masoudi FA, Holmes DR, Reddy VY, Price MJ, Curtis JP, Freeman JV. Patient-Level Analysis of Watchman Left Atrial Appendage Occlusion in Practice Versus Clinical Trials. JACC Cardiovascular Interventions 2022, 15: 950-961. PMID: 35512918, PMCID: PMC9370831, DOI: 10.1016/j.jcin.2022.02.029.Peer-Reviewed Original ResearchConceptsRegistry patientsHemorrhagic stroke riskIschemic strokeWarfarin patientsTrial patientsStroke riskLAAO patientsClinical practiceMore pericardial effusionsPeriprocedural ischemic strokePropensity-matched analysisAtrial appendage occlusionCox proportional hazardsPatient-level dataFine-Gray modelMore comorbiditiesPROTECT AFNoncardiovascular deathPericardial effusionHemorrhagic strokeAppendage occlusionDevice implantationTrial criteriaClinical trialsSimilar risk
2020
Effect of Temporary Interruption of Warfarin Due to an Intervention on Downstream Time in Therapeutic Range in Patients With Atrial Fibrillation (from ORBIT AF)
Madhavan M, Holmes DN, Piccini JP, Freeman JV, Fonarow GC, Hylek EM, Kowey PR, Mahaffey KW, Pieper K, Peterson ED, Chan PS, Allen LA, Singer DE, Naccarelli GV, Reiffel JA, Steinberg BA, Gersh BJ, Investigators O. Effect of Temporary Interruption of Warfarin Due to an Intervention on Downstream Time in Therapeutic Range in Patients With Atrial Fibrillation (from ORBIT AF). The American Journal Of Cardiology 2020, 132: 66-71. PMID: 32826041, DOI: 10.1016/j.amjcard.2020.07.006.Peer-Reviewed Original ResearchConceptsInternational normalized ratioFirst therapeutic international normalized ratioTherapeutic international normalized ratioTherapeutic rangeAtrial fibrillationMajor bleedingTemporary interruptionAF patientsSubtherapeutic international normalized ratioBetter Informed TreatmentLow therapeutic rangeProportional hazards modelOutcomes RegistryNormalized ratioHigh incidenceLower riskHazards modelPatientsInformed TreatmentWarfarinSubsequent outcomesMonthsAnticoagulationRank testWeeksOutcomes of Cardiac Catheterization in Patients With Atrial Fibrillation on Anticoagulation in Contemporary in Practice
Sherwood MW, Piccini JP, Holmes DN, Pieper KS, Steinberg BA, Fonarow GC, Allen LA, Naccarelli GV, Kowey PR, Gersh BJ, Mahaffey KW, Singer DE, Ansell JE, Freeman JV, Chan PS, Reiffel JA, Blanco R, Peterson ED, Rao SV. Outcomes of Cardiac Catheterization in Patients With Atrial Fibrillation on Anticoagulation in Contemporary in Practice. Circulation Cardiovascular Interventions 2020, 13: e008274. PMID: 32408815, DOI: 10.1161/circinterventions.119.008274.Peer-Reviewed Original ResearchMeSH KeywordsAdministration, OralAgedAnticoagulantsAtrial FibrillationCardiac CatheterizationDrug Administration ScheduleFactor Xa InhibitorsFemaleHemorrhageHumansMaleMiddle AgedPercutaneous Coronary InterventionPlatelet Aggregation InhibitorsRegistriesRisk AssessmentRisk FactorsStrokeTime FactorsTreatment OutcomeUnited StatesWarfarinConceptsDirect-Acting Oral AnticoagulantsActing Oral AnticoagulantsOral anticoagulationCardiac catheterizationRadial artery accessAtrial fibrillationMajor bleedingOral anticoagulantsMedian ageArtery accessAtrial Fibrillation II registryPatients' median ageReal-world registryChronic kidney diseaseThird of patientsBetter Informed TreatmentManagement of patientsOAC typeAntiplatelet therapyDiabetes mellitusFemoral accessContemporary cohortOutcomes RegistryKidney diseaseMyocardial infarctionSwitching warfarin to direct oral anticoagulants in atrial fibrillation: Insights from the NCDR PINNACLE registry
Sciria CT, Maddox TM, Marzec L, Rodwin B, Virani SS, Annapureddy A, Freeman JV, O'Hare A, Liu Y, Song Y, Doros G, Zheng Y, Lee JJ, Daggubati R, Vadlamani L, Cannon C, Desai NR. Switching warfarin to direct oral anticoagulants in atrial fibrillation: Insights from the NCDR PINNACLE registry. Clinical Cardiology 2020, 43: 743-751. PMID: 32378265, PMCID: PMC7368350, DOI: 10.1002/clc.23376.Peer-Reviewed Original ResearchConceptsDirect oral anticoagulantsAF patientsAtrial fibrillationOral anticoagulantsAvailability of DOACsChronic warfarin therapyMultivariable hierarchical regressionNCDR PINNACLE RegistryPattern of anticoagulationProspective cohort studyPractice-level factorsPractice-level variationPINNACLE RegistryPrescribed warfarinSwitched patientsClinical characteristicsCohort studyStroke riskWarfarin therapyCurrent guidelinesPatientsWarfarinAnticoagulationPrivate insuranceSignificant predictors
2019
Association Between Warfarin Control Metrics and Atrial Fibrillation Outcomes in the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation
Pokorney SD, Holmes DN, Thomas L, Fonarow GC, Kowey PR, Reiffel JA, Singer DE, Freeman JV, Gersh BJ, Mahaffey KW, Hylek EM, Naccarelli GV, Ezekowitz MD, Piccini JP, Peterson ED. Association Between Warfarin Control Metrics and Atrial Fibrillation Outcomes in the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation. JAMA Cardiology 2019, 4: 756-764. PMID: 31268487, PMCID: PMC6613340, DOI: 10.1001/jamacardio.2019.1960.Peer-Reviewed Original ResearchConceptsInternational normalized ratioBetter Informed TreatmentAtrial fibrillationTherapeutic rangeWarfarin controlThrombotic eventsINR valuesStroke riskClinical factorsOutcomes RegistrySubsequent bleedingInformed TreatmentMaximum international normalized ratioRecent international normalized ratioINR measuresNet reclassification improvement indexAtrial fibrillation outcomesAtrial Fibrillation RegistrySubsequent stroke riskMulticenter cohort studyClinical risk modelTraditional clinical factorsLogistic regression modelsINR controlMajor bleedsTreatment of atrial fibrillation with concomitant coronary or peripheral artery disease: Results from the outcomes registry for better informed treatment of atrial fibrillation II
Inohara T, Shrader P, Pieper K, Blanco RG, Allen LA, Fonarow GC, Gersh BJ, Go AS, Ezekowitz MD, Kowey PR, Reiffel JA, Naccarelli GV, Chan PS, Mahaffey KW, Singer DE, Freeman JV, Steinberg BA, Peterson ED, Piccini JP, Patients and Investigators O. Treatment of atrial fibrillation with concomitant coronary or peripheral artery disease: Results from the outcomes registry for better informed treatment of atrial fibrillation II. American Heart Journal 2019, 213: 81-90. PMID: 31129441, DOI: 10.1016/j.ahj.2019.04.007.Peer-Reviewed Original ResearchMeSH KeywordsAgedAnticoagulantsAtrial FibrillationCardiovascular DiseasesCoronary Artery DiseaseDrug Therapy, CombinationFactor Xa InhibitorsFemaleHemorrhageHumansMaleMiddle AgedMyocardial InfarctionMyocardial RevascularizationPeripheral Arterial DiseasePlatelet Aggregation InhibitorsProportional Hazards ModelsProspective StudiesRegistriesStrokeTreatment OutcomeWarfarinConceptsNew-onset atrial fibrillationDirect oral anticoagulantsConcomitant antiplatelet therapyPeripheral artery diseaseAtrial fibrillationVascular diseaseAntiplatelet therapyMajor bleedingArtery diseaseMyocardial infarctionORBIT-AF II registryAtrial Fibrillation IIImproved cardiovascular outcomesVascular disease patientsProportional hazards modelOutcomes of individualsOral anticoagulationCardiovascular outcomesOral anticoagulantsTriple therapyMost patientsPatient characteristicsCoronary diseaseDual therapyNeurological events
2018
Association of Race/Ethnicity With Oral Anticoagulant Use in Patients With Atrial Fibrillation: Findings From the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation II.
Essien UR, Holmes DN, Jackson LR, Fonarow GC, Mahaffey KW, Reiffel JA, Steinberg BA, Allen LA, Chan PS, Freeman JV, Blanco RG, Pieper KS, Piccini JP, Peterson ED, Singer DE. Association of Race/Ethnicity With Oral Anticoagulant Use in Patients With Atrial Fibrillation: Findings From the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation II. JAMA Cardiology 2018, 3: 1174-1182. PMID: 30484833, PMCID: PMC6583087, DOI: 10.1001/jamacardio.2018.3945.Peer-Reviewed Original ResearchConceptsDirect-acting oral anticoagulantsAtrial Fibrillation IIOral anticoagulant useOral anticoagulantsBetter Informed TreatmentAtrial fibrillationAnticoagulant useRace/ethnicityWhite individualsOutcomes RegistryHispanic individualsBlack individualsInformed TreatmentOne-year persistenceOral anticoagulant discontinuationQuality of anticoagulationEthnic differencesSelf-reported race/ethnicitySocioeconomic factorsQuality of careHispanic groupsAnticoagulant discontinuationDOAC useInappropriate dosingCohort studyPharmacotherapy for Atrial Fibrillation in Patients With Chronic Kidney Disease: Insights From ORBIT‐AF
Washam JB, Holmes DN, Thomas LE, Pokorney SD, Hylek EM, Fonarow GC, Mahaffey KW, Gersh BJ, Kowey PR, Ansell JE, Go AS, Reiffel JA, Freeman JV, Singer DE, Naccarelli G, Blanco R, Peterson ED, Piccini JP. Pharmacotherapy for Atrial Fibrillation in Patients With Chronic Kidney Disease: Insights From ORBIT‐AF. Journal Of The American Heart Association 2018, 7: e008928. PMID: 30371218, PMCID: PMC6222961, DOI: 10.1161/jaha.118.008928.Peer-Reviewed Original ResearchMeSH KeywordsAdministration, OralAgedAged, 80 and overAnti-Arrhythmia AgentsAnticoagulantsAtrial FibrillationDabigatranDrug Therapy, CombinationFemaleFollow-Up StudiesHumansMaleMiddle AgedProspective StudiesRegistriesRenal Insufficiency, ChronicRisk FactorsStrokeTime FactorsTreatment OutcomeWarfarinConceptsBackground Chronic kidney diseaseAntiarrhythmic drug useTransient ischemic attackChronic kidney diseaseAtrial fibrillationAdvanced CKDCKD statusIschemic attackSystemic embolismCause mortalityCreatinine clearanceRhythm controlKidney diseaseDrug useAtrial fibrillation scoreBaseline renal functionOral anticoagulant useRhythm control strategyCox proportional hazardsCKD patientsMajor bleedingOAC useCardiovascular deathCKD stageHigher CHA
2016
Cost-Effectiveness of Percutaneous Closure of the Left Atrial Appendage in Atrial Fibrillation Based on Results From PROTECT AF Versus PREVAIL
Freeman JV, Hutton DW, Barnes GD, Zhu RP, Owens DK, Garber AM, Go AS, Hlatky MA, Heidenreich PA, Wang PJ, Al-Ahmad A, Turakhia MP. Cost-Effectiveness of Percutaneous Closure of the Left Atrial Appendage in Atrial Fibrillation Based on Results From PROTECT AF Versus PREVAIL. Circulation Arrhythmia And Electrophysiology 2016, 9: e003407. PMID: 27307517, PMCID: PMC4911813, DOI: 10.1161/circep.115.003407.Peer-Reviewed Original ResearchConceptsLAA closureLeft atrial appendageQuality-adjusted life yearsPROTECT AFAtrial fibrillationPercutaneous closureWatchman deviceAtrial appendageLife yearsTrial dataWATCHMAN LAA closure devicePROTECT AF trialIncremental cost-effectiveness ratioMajor adverse eventsPrevention of strokeAtrial appendage closureProspective Randomized EvaluationLAA closure deviceLong-term trial resultsQuality-adjusted survivalCost-effectiveness ratioCost-effectiveness resultsMedical anticoagulationAF trialAdverse events
2010
Cost-effectiveness of dabigatran compared with warfarin for stroke prevention in atrial fibrillation.
Freeman JV, Zhu RP, Owens DK, Garber AM, Hutton DW, Go AS, Wang PJ, Turakhia MP. Cost-effectiveness of dabigatran compared with warfarin for stroke prevention in atrial fibrillation. Annals Of Internal Medicine 2010, 154: 1-11. PMID: 21041570, DOI: 10.7326/0003-4819-154-1-201101040-00289.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overAnticoagulantsAtrial FibrillationBenzimidazolesBeta-AlanineCost-Benefit AnalysisDabigatranFibrinolytic AgentsHemorrhageHumansIntracranial HemorrhagesIschemic Attack, TransientMarkov ChainsMyocardial InfarctionQuality-Adjusted Life YearsRisk FactorsSensitivity and SpecificityStrokeWarfarinConceptsHigh-dose dabigatranIncremental cost-effectiveness ratioNonvalvular atrial fibrillationLow-dose dabigatranCost-effectiveness ratioAtrial fibrillationIschemic strokeCost of dabigatranIntracranial hemorrhageClinical trialsOral direct thrombin inhibitorVeterans Affairs Health Services ResearchSingle randomized clinical trialAdjusted-dose warfarinStudies of anticoagulationPatients 65 yearsRE-LY trialDirect thrombin inhibitorRandomized clinical trialsAmerican Heart AssociationQuality-adjusted life expectancyQuality-adjusted survivalBase-case analysisHealth services researchStroke prevention