2021
Antithrombotic Therapy for Stroke Prevention in Patients With Ischemic Stroke With Aspirin Treatment Failure
Lusk J, Xu H, Peterson E, Bhatt D, Fonarow G, Smith E, Matsouaka R, Schwamm L, Xian Y. Antithrombotic Therapy for Stroke Prevention in Patients With Ischemic Stroke With Aspirin Treatment Failure. Stroke 2021, 52: e777-e781. PMID: 34702067, PMCID: PMC8608737, DOI: 10.1161/strokeaha.121.034622.Peer-Reviewed Original ResearchConceptsAspirin treatment failureDual antiplatelet therapyIschemic strokeAspirin monotherapyClopidogrel monotherapyAntiplatelet therapyAntithrombotic therapyTreatment failureAntithrombotic treatment patternsAspirin/dipyridamoleGuidelines-Stroke registryIschemic stroke survivorsAcute ischemic strokeHalf of patientsAmerican Heart AssociationComplex clinical scenariosNonvitamin KOral anticoagulantsStroke preventionStroke RegistryOlder patientsPreventive therapyTreatment patternsHeart AssociationStroke survivors
2020
Target: Stroke Was Associated With Faster Intravenous Thrombolysis and Improved One-Year Outcomes for Acute Ischemic Stroke in Medicare Beneficiaries
Man S, Xian Y, Holmes D, Matsouaka R, Saver J, Smith E, Bhatt D, Schwamm L, Fonarow G. Target: Stroke Was Associated With Faster Intravenous Thrombolysis and Improved One-Year Outcomes for Acute Ischemic Stroke in Medicare Beneficiaries. Circulation Cardiovascular Quality And Outcomes 2020, 13: e007150. PMID: 33302714, DOI: 10.1161/circoutcomes.120.007150.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overDatabases, FactualFemaleFibrinolytic AgentsHumansInfusions, IntravenousInsurance BenefitsIschemic StrokeMaleMedicarePatient ReadmissionQuality ImprovementQuality Indicators, Health CareRetrospective StudiesRisk AssessmentRisk FactorsThrombolytic TherapyTime FactorsTime-to-TreatmentTreatment OutcomeUnited StatesConceptsAcute ischemic strokeIschemic strokeNeedle timeIntravenous thrombolysisCardiovascular readmissionCause mortalityThrombolytic treatmentThrombolytic therapyMedicare beneficiariesGuidelines-Stroke hospitalsIntravenous thrombolytic therapyIntravenous thrombolytic treatmentOne-year outcomesProportion of patientsProportional hazards analysisAmerican Heart AssociationQuality InitiativeCause readmissionMedian doorHospital clusteringMedian ageHeart AssociationHospital characteristicsReadmissionImproved door
2017
Professional Medical Interpreters Influence the Quality of Acute Ischemic Stroke Care for Patients Who Speak Languages Other than English
Erfe B, Siddiqui K, Schwamm L, Kirwan C, Nunes A, Mejia N. Professional Medical Interpreters Influence the Quality of Acute Ischemic Stroke Care for Patients Who Speak Languages Other than English. Journal Of The American Heart Association 2017, 6: e006175. PMID: 28935679, PMCID: PMC5634277, DOI: 10.1161/jaha.117.006175.Peer-Reviewed Original ResearchConceptsProfessional medical interpretersMedical interpretersAcute ischemic stroke careIschemic stroke careAcute ischemic stroke patientsIschemic stroke patientsStroke carePMI servicesCommon languageEnglishLanguageStroke patientsInterpretersGuidelines-Stroke programAmerican Heart AssociationAppropriate health careLogistic regression modelsQuality patient careHospital stayMultivariable analysisPatient receiptHeart AssociationLower oddsPatientsMedical careAmerican Heart Association’s Call to Action for Payment and Delivery System Reform
Bufalino V, Berkowitz S, Gardner T, Piña I, Konig M, Bauman M, Barbouche M, Creager M, Fonarow G, Gibbons R, Meltzer D, Meltzer N, Schwamm L, Warner J. American Heart Association’s Call to Action for Payment and Delivery System Reform. Circulation 2017, 136: e162-e171. PMID: 28696250, DOI: 10.1161/cir.0000000000000516.Peer-Reviewed Original ResearchConceptsAmerican Heart AssociationHeart AssociationDelivery system reformPatient-centered medical homeExpert panelDelivery system transformationAccountable care organizationsMedical homeHealth professionalsPatient careMedical careInterests of patientsBaseline reviewHealthcare systemCare organizationsParticular medicinePrivate payersAssociationPayment modelsCareDelivery modelAlternative deliverySystem reformFurther involvementPatientsThe American Heart Association’s Get With the Guidelines (GWTG)-Stroke development and impact on stroke care
Ormseth CH, Sheth KN, Saver JL, Fonarow GC, Schwamm LH. The American Heart Association’s Get With the Guidelines (GWTG)-Stroke development and impact on stroke care. Stroke And Vascular Neurology 2017, 2: 94. PMID: 28959497, PMCID: PMC5600018, DOI: 10.1136/svn-2017-000092.Peer-Reviewed Original ResearchConceptsStroke care deliveryAmerican Heart AssociationHeart AssociationCare deliveryEvidence-based careContinuous quality improvement initiativesQuality improvement initiativesInpatient outcomesStroke ProgramPatient characteristicsStroke outcomeStroke careStroke developmentVoluntary registryPatient outcomesHospital adherenceImprovement initiativesOutcomesCareGuidelinesAssociationGWTGDeliveryRegistry
2016
Relationship Between Language Preference and Intravenous Thrombolysis Among Acute Ischemic Stroke Patients
Erfe B, Siddiqui K, Schwamm L, Mejia N. Relationship Between Language Preference and Intravenous Thrombolysis Among Acute Ischemic Stroke Patients. Journal Of The American Heart Association 2016, 5: e003782. PMID: 27881425, PMCID: PMC5210419, DOI: 10.1161/jaha.116.003782.Peer-Reviewed Original ResearchConceptsLanguage preferencePatients' language preferenceAcute ischemic stroke patientsNon-English languageIschemic stroke patientsNIH Stroke ScaleAIS patientsDifferent languagesInitial NIH stroke scaleIntravenous thrombolysisPatient languageStroke ScaleStroke patientsLanguageStepwise logistic regression modelInitial stroke severityAmerican Heart AssociationEnglishLogistic regression modelsStroke severityMultivariable analysisPatient receiptHeart AssociationThrombolysisPatientsAssociation of Get With The Guidelines-Stroke Program Participation and Clinical Outcomes for Medicare Beneficiaries With Ischemic Stroke
Song S, Fonarow G, Olson D, Liang L, Schulte P, Hernandez A, Peterson E, Reeves M, Smith E, Schwamm L, Saver J. Association of Get With The Guidelines-Stroke Program Participation and Clinical Outcomes for Medicare Beneficiaries With Ischemic Stroke. Stroke 2016, 47: 1294-1302. PMID: 27079809, PMCID: PMC4975426, DOI: 10.1161/strokeaha.115.011874.Peer-Reviewed Original ResearchConceptsAcute ischemic stroke admissionsGWTG-Stroke programIschemic stroke admissionsClinical outcomesStroke admissionsMedicare beneficiariesAcute care US hospitalsHospital-based quality improvement programsGWTG-Stroke hospitalsImproved functional outcomesAmerican Heart AssociationQuality Improvement ProgramGWTG-StrokePostdischarge mortalityAcute strokeIschemic strokeFunctional outcomeHeart AssociationNonparticipating hospitalsStroke hospitalsHospital participationUS hospitalsHospitalPre periodSimilar hospitals
2014
Improving Door-to-Needle Times
Ruff I, Ali S, Goldstein J, Lev M, Copen W, McIntyre J, Rost N, Schwamm L. Improving Door-to-Needle Times. Stroke 2014, 45: 504-508. PMID: 24399372, DOI: 10.1161/strokeaha.113.004073.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overClinical ProtocolsComorbidityData Interpretation, StatisticalEarly DiagnosisEmergency Medical ServicesFemaleFibrinolytic AgentsHumansInternational Classification of DiseasesMaleMiddle AgedProspective StudiesQuality ImprovementRetrospective StudiesSocioeconomic FactorsStrokeThrombolytic TherapyTissue Plasminogen ActivatorTomography, X-Ray ComputedTreatment OutcomeConceptsIntravenous tissue-type plasminogen activatorEmergency department arrivalTissue-type plasminogen activatorAcute strokeDTN timeNeedle timeHealth Stroke Scale scorePlasminogen activatorAcute ischemic strokePercentage of patientsStroke Scale scoreAmerican Heart AssociationStroke care modelWilcoxon signed-rank testImproving DoorIschemic strokeStroke guidelinesHeart AssociationPostintervention periodSigned-rank testPre interventionCare modelNational guidelinesPost interventionPatients
2013
Quality of Care and Outcomes for In-Hospital Ischemic Stroke
Cumbler E, Wald H, Bhatt D, Cox M, Xian Y, Reeves M, Smith E, Schwamm L, Fonarow G. Quality of Care and Outcomes for In-Hospital Ischemic Stroke. Stroke 2013, 45: 231-238. PMID: 24253540, DOI: 10.1161/strokeaha.113.003617.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overBrain IschemiaCohort StudiesComorbidityConfidence IntervalsDatabases, FactualFemaleGuideline AdherenceHumansMaleMiddle AgedOdds RatioQuality ImprovementQuality of Health CareRegistriesRetrospective StudiesSocioeconomic FactorsStrokeThrombolytic TherapyTreatment OutcomeConceptsHospital strokeIschemic strokeSevere strokePatient characteristicsIn-Hospital Ischemic StrokeProcess-based quality measuresCommunity-onset strokeDefect-free careGuidelines-Stroke databaseRetrospective cohort studyThromboembolic risk factorsProportion of patientsHospital ischemic strokeAmerican Heart AssociationTargeted quality improvement effortsQuality of careProsthetic heart valvesQuality improvement effortsHospital mortalityComorbid illnessesCohort studyHeart failureAtrial fibrillationCarotid stenosisHeart AssociationComparison of Performance Achievement Award Recognition With Primary Stroke Center Certification for Acute Ischemic Stroke Care
Fonarow G, Liang L, Smith E, Reeves M, Saver J, Xian Y, Hernandez A, Peterson E, Schwamm L, Committee & Investigators G. Comparison of Performance Achievement Award Recognition With Primary Stroke Center Certification for Acute Ischemic Stroke Care. Journal Of The American Heart Association 2013, 2: e000451. PMID: 24125846, PMCID: PMC3835260, DOI: 10.1161/jaha.113.000451.Peer-Reviewed Original ResearchConceptsPrimary stroke center certificationStroke center certificationAcute ischemic strokeHospital characteristicsIschemic strokeCenter certificationAcute ischemic stroke careStroke performance measuresIschemic stroke careAmerican Heart AssociationPSC certificationPatient characteristicsStroke careStroke measuresHeart AssociationCare measuresHigher oddsPatientsHospitalPSC statusStroke qualityHospital certificationStrokeCareTemporal Trends in Patient Characteristics and Treatment With Intravenous Thrombolysis Among Acute Ischemic Stroke Patients at Get With the Guidelines–Stroke Hospitals
Schwamm L, Ali S, Reeves M, Smith E, Saver J, Messe S, Bhatt D, Grau-Sepulveda M, Peterson E, Fonarow G. Temporal Trends in Patient Characteristics and Treatment With Intravenous Thrombolysis Among Acute Ischemic Stroke Patients at Get With the Guidelines–Stroke Hospitals. Circulation Cardiovascular Quality And Outcomes 2013, 6: 543-549. DOI: 10.1161/circoutcomes.111.000095.Peer-Reviewed Original ResearchAcute ischemic stroke patientsIschemic stroke patientsTPA useAIS patientsPatient characteristicsStroke patientsHospitalized acute ischemic stroke patientsIntravenous tissue plasminogen activator useTissue plasminogen activator useNonwhite race/ethnicityAdditional calendar yearGuidelines-Stroke hospitalsAmerican Heart AssociationRace/ethnicityAIS admissionsGuidelines-StrokeEligible patientsIntravenous thrombolysisIntravenous tPAMore patientsMultivariable analysisHeart AssociationMild strokeTPA timeUnivariate analysisTemporal trends in patient characteristics and treatment with intravenous thrombolysis among acute ischemic stroke patients at Get With The Guidelines-Stroke hospitals.
Schwamm L, Ali S, Reeves M, Smith E, Saver J, Messe S, Bhatt D, Grau-Sepulveda M, Peterson E, Fonarow G. Temporal trends in patient characteristics and treatment with intravenous thrombolysis among acute ischemic stroke patients at Get With The Guidelines-Stroke hospitals. Circulation Cardiovascular Quality And Outcomes 2013, 6: 543-9. PMID: 24046398, DOI: 10.1161/circoutcomes.111.000303.Peer-Reviewed Original ResearchMeSH KeywordsAdministration, IntravenousAge FactorsAgedAged, 80 and overAmerican Heart AssociationBrain IschemiaChi-Square DistributionFemaleFibrinolytic AgentsHospitalsHumansMaleMiddle AgedMultivariate AnalysisOdds RatioQuality Indicators, Health CareRegistriesRisk FactorsStrokeThrombolytic TherapyTime FactorsTime-to-TreatmentTissue Plasminogen ActivatorTreatment OutcomeUnited StatesConceptsAcute ischemic stroke patientsIschemic stroke patientsTPA useAIS patientsPatient characteristicsStroke patientsHospitalized acute ischemic stroke patientsIntravenous tissue plasminogen activator useTissue plasminogen activator useNonwhite race/ethnicityAdditional calendar yearGuidelines-Stroke hospitalsAmerican Heart AssociationRace/ethnicityAIS admissionsGuidelines-StrokeEligible patientsIntravenous thrombolysisIntravenous tPAMore patientsMultivariable analysisHeart AssociationMild strokeTPA timeUnivariate analysisReview of Stroke Center Effectiveness and Other Get with the Guidelines Data
Silva G, Schwamm L. Review of Stroke Center Effectiveness and Other Get with the Guidelines Data. Current Atherosclerosis Reports 2013, 15: 350. PMID: 23892766, DOI: 10.1007/s11883-013-0350-8.Peer-Reviewed Original ResearchConceptsStroke systemsAcute careAcute stroke-ready hospitalGuidelines-Stroke programSpectrum of strokeStroke-ready hospitalsComprehensive stroke centerBest evidence-based careEvidence-based careAmerican Heart AssociationEmergency medical servicesSecondary preventionStroke centersStroke carePrimary preventionHeart AssociationCoordinated careCare processesPatient accessCareCare comprisesStrokeMedical servicesPreventionGuideline dataRacial and Ethnic Differences in Outcomes in Older Patients With Acute Ischemic Stroke
Qian F, Fonarow G, Smith E, Xian Y, Pan W, Hannan E, Shaw B, Glance L, Peterson E, Eapen Z, Hernandez A, Schwamm L, Bhatt D. Racial and Ethnic Differences in Outcomes in Older Patients With Acute Ischemic Stroke. Circulation Cardiovascular Quality And Outcomes 2013, 6: 284-292. PMID: 23680966, DOI: 10.1161/circoutcomes.113.000211.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsAgedAged, 80 and overBlack or African AmericanBrain IschemiaEthnicityFemaleHealth Status DisparitiesHealthcare DisparitiesHispanic or LatinoHumansLogistic ModelsMaleMedicareMultivariate AnalysisOdds RatioPatient ReadmissionRacial GroupsRegistriesRisk FactorsSeverity of Illness IndexStrokeTime FactorsTreatment OutcomeUnited StatesWhite PeopleConceptsAcute ischemic strokeLong-term outcomesRace/ethnicityCause rehospitalizationOlder patientsIschemic strokeUnadjusted mortalityHispanic patientsGuidelines-Stroke programGuidelines-Stroke registryHealth Stroke ScaleOlder Medicare beneficiariesAmerican Heart AssociationAsian American patientsYears of ageStroke ScaleStroke severityHigher median scoresAsian patientsHeart AssociationHospital characteristicsAmerican patientsUS CentersPrognostic variablesLower oddsAge Differences in the Use of Implantable Cardioverter‐Defibrillators Among Older Patients Hospitalized with Heart Failure
HESS P, GRAU‐SEPULVEDA M, HERNANDEZ A, PETERSON E, BHATT D, SCHWAMM L, YANCY C, FONAROW G, AL‐KHATIB S, Committee and Hospitals F. Age Differences in the Use of Implantable Cardioverter‐Defibrillators Among Older Patients Hospitalized with Heart Failure. Journal Of Cardiovascular Electrophysiology 2013, 24: 664-671. PMID: 23437793, PMCID: PMC4076932, DOI: 10.1111/jce.12100.Peer-Reviewed Original ResearchConceptsLeft ventricular ejection fractionHeart failureAge groupsPatient ageGuideline-eligible patientsGuidelines-HF ProgramAbsence of contraindicationsVentricular ejection fractionAmerican Heart AssociationUse of ICDsImplantable cardioverter defibrillatorOlder age groupsSame age groupOlder patientsEjection fractionICD useICD placementHeart AssociationAge-related differencesPractice guidelinesCardioverter defibrillatorPatientsHospitalizationICDAge
2012
Trends in Smoking Cessation Counseling: Experience From American Heart Association‐Get With The Guidelines
Huang P, Kim C, Lerman A, Cannon C, Dai D, Laskey W, Peacock W, Hernandez A, Peterson E, Smith E, Fonarow G, Schwamm L, Bhatt D. Trends in Smoking Cessation Counseling: Experience From American Heart Association‐Get With The Guidelines. Clinical Cardiology 2012, 35: 396-403. PMID: 22753250, PMCID: PMC6652349, DOI: 10.1002/clc.22023.Peer-Reviewed Original ResearchMeSH KeywordsAgedAmerican Heart AssociationCardiovascular DiseasesChi-Square DistributionCounselingFemaleGuideline AdherenceHumansMaleMiddle AgedMultivariate AnalysisPractice Guidelines as TopicQuality ImprovementRisk AssessmentRisk FactorsRisk Reduction BehaviorSmokingSmoking CessationSmoking PreventionTime FactorsUnited StatesConceptsAmerican Heart AssociationGWTG-CADGWTG-StrokeHeart AssociationSystematic quality improvement programmeCoronary artery disease patientsNational guideline recommendationsSuccessful smoking cessationQuality Improvement ProgramCessation counselingSmoking contributesStroke admissionsGuideline recommendationsRecent smokersSignificant morbidityStroke careStroke patientsSmoking cessationDisease patientsCardiovascular carePatientsAdmissionStudy periodStrokeCareAge and Gender Differences in Quality of Care and Outcomes for Patients with ST-segment Elevation Myocardial Infarction
Bangalore S, Fonarow G, Peterson E, Hellkamp A, Hernandez A, Laskey W, Peacock W, Cannon C, Schwamm L, Bhatt D, Committee and Investigators G. Age and Gender Differences in Quality of Care and Outcomes for Patients with ST-segment Elevation Myocardial Infarction. The American Journal Of Medicine 2012, 125: 1000-1009. PMID: 22748404, DOI: 10.1016/j.amjmed.2011.11.016.Peer-Reviewed Original ResearchMeSH KeywordsAdultAge FactorsAgedAged, 80 and overCohort StudiesFemaleGuideline AdherenceHealthcare DisparitiesHospital MortalityHumansMaleMiddle AgedMultivariate AnalysisMyocardial InfarctionOutcome and Process Assessment, Health CarePractice Guidelines as TopicPrognosisQuality Indicators, Health CareRegistriesRisk FactorsSex FactorsUnited StatesConceptsST-segment elevation myocardial infarctionElevation myocardial infarctionQuality of careYounger patientsMyocardial infarctionHospital outcomesOlder patientsST-segment elevation myocardial infarction casesGuidelines-Coronary Artery Disease registryTraditional cardiovascular risk factorsCoronary Artery Disease registryCardiovascular risk factorsAmerican Heart AssociationMyocardial infarction casesOlder counterpartsYounger cohortsTime trend analysisHospital mortalityHospital deathHeart AssociationRisk factorsWorse outcomesInfarction casesThrombolytic timeDisease RegistryRisks of Intracranial Hemorrhage Among Patients With Acute Ischemic Stroke Receiving Warfarin and Treated With Intravenous Tissue Plasminogen Activator
Xian Y, Liang L, Smith E, Schwamm L, Reeves M, Olson D, Hernandez A, Fonarow G, Peterson E. Risks of Intracranial Hemorrhage Among Patients With Acute Ischemic Stroke Receiving Warfarin and Treated With Intravenous Tissue Plasminogen Activator. JAMA 2012, 307: 2600-2608. PMID: 22735429, DOI: 10.1001/jama.2012.6756.Peer-Reviewed Original ResearchConceptsIntravenous tissue plasminogen activatorInternational normalized ratioSymptomatic intracranial hemorrhageTissue plasminogen activatorSerious systemic hemorrhageIschemic strokeIntracranial hemorrhageSICH riskHospital mortalitySystemic hemorrhagePlasminogen activatorBaseline clinical factorsChronic warfarin therapyGuidelines-Stroke registrySecondary end pointsDegree of anticoagulationAmerican Heart AssociationRegistry hospitalsSICH rateSevere strokeWarfarin therapyClinical factorsComorbid conditionsHeart AssociationNormalized ratioData quality in the American Heart Association Get With The Guidelines-Stroke (GWTG-Stroke): Results from a National Data Validation Audit
Xian Y, Fonarow G, Reeves M, Webb L, Blevins J, Demyanenko V, Zhao X, Olson D, Hernandez A, Peterson E, Schwamm L, Smith E. Data quality in the American Heart Association Get With The Guidelines-Stroke (GWTG-Stroke): Results from a National Data Validation Audit. American Heart Journal 2012, 163: 392-398.e1. PMID: 22424009, DOI: 10.1016/j.ahj.2011.12.012.Peer-Reviewed Original ResearchConceptsMedical recordsDeep venous thrombosis prophylaxisPrimary stroke center certificationGWTG-Stroke hospitalsHospital academic statusStroke center certificationVenous thrombosis prophylaxisNational Stroke RegistryAmerican Heart AssociationQuality Improvement ProgramIntraclass correlationIschemic stroke volumeGuidelines-StrokeGWTG-StrokeStroke RegistryThrombosis prophylaxisNeedle timeSerum creatinineSymptom onsetHeart AssociationCenter certificationStroke volumeRegistry dataRegistry participationCategorical variablesCare and Outcomes of Asian-American Acute Myocardial Infarction Patients
Qian F, Ling F, Deedwania P, Hernandez A, Fonarow G, Cannon C, Peterson E, Peacock W, Kaltenbach L, Laskey W, Schwamm L, Bhatt D. Care and Outcomes of Asian-American Acute Myocardial Infarction Patients. Circulation Cardiovascular Quality And Outcomes 2012, 5: 126-133. PMID: 22235068, DOI: 10.1161/circoutcomes.111.961987.Peer-Reviewed Original ResearchConceptsGuidelines-Coronary Artery Disease programAcute myocardial infarctionAMI patientsDisease programsBalloon timeWhite patientsAcute myocardial infarction patientsAMI performance measuresDefect-free careHospital mortality rateEvidence-based careAmerican Heart AssociationMyocardial infarction patientsAsian American patientsUnited States CentersHospital mortalityCessation counselingUnadjusted mortalityHeart failureHeart AssociationInfarction patientsMyocardial infarctionHigh prevalenceClinical careMortality rate