2024
Racial and Ethnic Disparities in the Use and Outcomes With WATCHMAN FLX: A SURPASS Analysis of the NCDR Left Atrial Appendage Occlusion Registry.
Alli O, Garg J, Boursiquot B, Kapadia S, Yeh R, Price M, Piccini J, Nair D, Hsu J, Gibson D, Allocco D, Christen T, Sutton B, Freeman J. Racial and Ethnic Disparities in the Use and Outcomes With WATCHMAN FLX: A SURPASS Analysis of the NCDR Left Atrial Appendage Occlusion Registry. Journal Of The American Heart Association 2024, e036406. PMID: 39575715, DOI: 10.1161/jaha.124.036406.Peer-Reviewed Original ResearchLeft atrial appendage occlusionWatchman FLX implantationBlack patientsHispanic patientsOral anticoagulantsProcedural successRates of 1-year deathWhite patientsAlternative to oral anticoagulationRate of procedural successEthnic minority groupsEthnic minority individualsRate of deathSignificant bleedingWatchman FLXMinority individualsAppendage occlusionAntiplatelet therapyBaseline characteristicsAtrial fibrillationAnalyses assessed differencesMinority groupsPatientsStroke preventionBleedingAssociation of Physician Certification and Outcomes Among Patients Undergoing Left Atrial Appendage Occlusion
Vora A, Pereira L, Du C, Tan Z, Huang C, Friedman D, Wang Y, Faridi K, Lakkireddy D, Zimmerman S, Higgins A, Kapadia S, Curtis J, Freeman J. Association of Physician Certification and Outcomes Among Patients Undergoing Left Atrial Appendage Occlusion. JACC Cardiovascular Interventions 2024 PMID: 39474982, DOI: 10.1016/j.jcin.2024.10.020.Peer-Reviewed Original ResearchPhysician certificationAppendage occlusionAdverse eventsPercutaneous left atrial appendage occlusionLong-term oral anticoagulationDischarged patientsMultivariate Cox proportional hazards regression analysisRate of procedural complicationsLeft atrial appendage occlusionCox proportional hazards regression analysisProportional hazards regression analysisRisk of adverse eventsHazards regression analysisIn-hospital deathOral anticoagulantsWatchman FLXNo significant differenceLAAO devicesProcedural complicationsStratify patientsIntracardiac echocardiographyAtrial fibrillationEligible patientsIdentified patientsMultivariable adjustment
2023
Research Opportunities in Stroke Prevention for Atrial Fibrillation: A Report From a National Heart, Lung, and Blood Institute Virtual Workshop
Go A, Al-Khatib S, Desvigne-Nickens P, Bansal N, Bushnell C, Fang M, Freeman J, Gage B, Hanke T, Hylek E, Lopes R, Noseworthy P, Reddy V, Singer D, Thomas K, Hills M, Turakhia M, Zieman S, Cooper L, Benjamin E. Research Opportunities in Stroke Prevention for Atrial Fibrillation: A Report From a National Heart, Lung, and Blood Institute Virtual Workshop. Stroke 2023, 54: e75-e85. PMID: 36848427, PMCID: PMC9995163, DOI: 10.1161/strokeaha.121.038273.Peer-Reviewed Original ResearchConceptsAtrial fibrillationStroke preventionNational HeartRisk factorsPercutaneous left atrial appendage occlusionLeft atrial appendage occlusionStroke prevention therapyAF risk factorsStroke prevention strategiesRisk stratification toolAtrial appendage occlusionStrong risk factorIndividual patient levelOral anticoagulantsIschemic strokePrevention therapyAppendage occlusionStratification toolIntracranial hemorrhageLeading causeCardiovascular diseasePatient levelPrevention strategiesOptimal rolePrevention
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 occlusion
2021
Change in hospitalization rates following transcatheter left atrial appendage occlusion
Mohammed M, Kattel S, Ahsan I, Samdani AJ, Chand S, Rai D, Bandyopadhyay D, Ranka S, Noheria A, Gupta SK, Sheldon SH, Rao M, Aronow WS, Freeman JV, Reddy M. Change in hospitalization rates following transcatheter left atrial appendage occlusion. Archives Of Medical Science - Atherosclerotic Diseases 2021, 6: e191-e195. PMID: 36161215, PMCID: PMC9487831, DOI: 10.5114/amsad.2021.111405.Peer-Reviewed Original ResearchAtrial appendage occlusionOral anticoagulantsAtrial fibrillationAppendage occlusionHospitalization ratesLong-term oral anticoagulantsNon-valvular atrial fibrillationDiagnosis of AFNationwide Readmissions DatabaseCause admissionsHospital stayIndex procedureMore admissionsHigh riskPatientsClinical practiceAverage preAdmissionMortality informationLAAOSignificant decreaseContraindicationsIncidenceMonthsOcclusionDosing of Direct Oral Anticoagulants in Patients with Moderate Chronic Kidney Disease in US Clinical Practice: Results from the Outcomes Registry for Better Informed Treatment of AF (ORBIT-AF II)
Jackson LR, Schrader P, Thomas L, Steinberg BA, Blanco R, Allen LA, Fonarow GC, Freeman JV, Gersh BJ, Kowey PR, Mahaffey KW, Naccarelli G, Reiffel J, Singer DE, Peterson ED, Piccini JP. Dosing of Direct Oral Anticoagulants in Patients with Moderate Chronic Kidney Disease in US Clinical Practice: Results from the Outcomes Registry for Better Informed Treatment of AF (ORBIT-AF II). American Journal Of Cardiovascular Drugs 2021, 21: 553-561. PMID: 33786798, DOI: 10.1007/s40256-021-00473-x.Peer-Reviewed Original ResearchConceptsModerate chronic kidney diseaseChronic kidney diseaseAtrial fibrillationRoutine clinical practiceClinical practiceInappropriate dosingOral anticoagulantsKidney diseaseConclusionIn routine clinical practiceMedian CHA2DS2VASc scoreComorbid medical conditionsDirect oral anticoagulantsUS clinical practiceBetter Informed TreatmentCockcroft-Gault formulaOne-thirdML/minCrCl 30CHA2DS2VASc scoreCreatinine clearanceRenal functionMedian ageDosage adjustmentOutcomes RegistryPrescribed doses
2020
Patterns of oral anticoagulation use with cardioversion in clinical practice
Geurink K, Holmes D, Ezekowitz MD, Pieper K, Fonarow G, Kowey PR, Reiffel JA, Singer DE, Freeman J, Gersh BJ, Mahaffey KW, Hylek EM, Naccarelli G, Piccini JP, Peterson ED, Pokorney SD. Patterns of oral anticoagulation use with cardioversion in clinical practice. Heart 2020, 107: 642-649. PMID: 32591363, DOI: 10.1136/heartjnl-2019-316315.Peer-Reviewed Original ResearchConceptsStroke/transient ischemic attackVitamin K antagonistsNovel oral anticoagulantsTransient ischemic attackTransoesophageal echocardiogramAtrial fibrillationClinical practiceAtrial Fibrillation IIOral anticoagulation useTime of cardioversionBetter Informed TreatmentMonths of enrollmentIncidence of deathLow-risk procedureSimilar ratesAnticoagulation useIschemic attackMajor bleedingK antagonistsOral anticoagulantsClinical outcomesOutcomes RegistryCardiovascular hospitalisationAF diagnosisInclusion criteriaOutcomes 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 predictorsDecline in renal function and oral anticoagulation dose reduction among patients with atrial fibrillation
Inohara T, Holmes DN, Pieper K, Blanco RG, Allen LA, Fonarow GC, Gersh BJ, Hylek EM, Ezekowitz MD, Kowey PR, Reiffel JA, Naccarelli GV, Chan PS, Mahaffey KW, Singer DE, Freeman JV, Steinberg BA, Peterson ED, Piccini JP. Decline in renal function and oral anticoagulation dose reduction among patients with atrial fibrillation. Heart 2020, 106: heartjnl-2019-315792. PMID: 31911503, DOI: 10.1136/heartjnl-2019-315792.Peer-Reviewed Original ResearchConceptsAtrial fibrillationRenal functionOral anticoagulationDose reductionAtrial Fibrillation II registryBetter Informed TreatmentML/minCrCl declineOral anticoagulantsCreatinine clearanceOutcomes RegistryGuideline criteriaPatientsPackage insertsUS FoodDrug AdministrationMean declineInformed TreatmentNOACsAnticoagulationFibrillationRegistryDosingCrClOne-fourth
2019
Treatment 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 eventsNON VITAMIN K ORAL ANTICOAGULANTS ARE NOT ASSOCIATED WITH INCREASED RISK OF PERIOPERATIVE BLEEDING IN PATIENTS UNDERGOING CARDIAC SURGERY
Waldron N, Shrader P, Levy J, Allen L, Chan P, Ezekowitz M, Fonarow G, Freeman J, Gersh B, Hylek E, Kowey P, Mahaffey K, Naccarelli G, Reiffel J, Singer D, Steinberg B, Peterson E, Piccini J. NON VITAMIN K ORAL ANTICOAGULANTS ARE NOT ASSOCIATED WITH INCREASED RISK OF PERIOPERATIVE BLEEDING IN PATIENTS UNDERGOING CARDIAC SURGERY. Journal Of The American College Of Cardiology 2019, 73: 547. DOI: 10.1016/s0735-1097(19)31155-6.Peer-Reviewed Original Research
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 studyPrognostic Significance of Nuisance Bleeding in Anticoagulated Patients With Atrial Fibrillation
O'Brien EC, Holmes DN, Thomas LE, Fonarow GC, Allen LA, Gersh BJ, Kowey PR, Singer DE, Ezekowitz MD, Naccarelli GV, Ansell JE, Chan PS, Mahaffey KW, Go AS, Freeman JV, Reiffel JA, Peterson ED, Piccini JP, Hylek EM. Prognostic Significance of Nuisance Bleeding in Anticoagulated Patients With Atrial Fibrillation. Circulation 2018, 138: 889-897. PMID: 29678813, DOI: 10.1161/circulationaha.117.031354.Peer-Reviewed Original ResearchConceptsStroke/systemic embolismMajor bleedingOral anticoagulantsAtrial fibrillationMinor bleeding eventsSubset of patientsVASc risk scorePooled logistic regressionYears of ageBleeding eventsEligible followOAC discontinuationOAC therapyOutpatient registrySystemic embolismAnticoagulated patientsMinor bleedingMedian ageTreatment satisfactionPrognostic significanceNuisance bleedingMedical recordsORBIT-AFIncidence ratePatient visitsFrequency and Outcomes of Reduced Dose Non–Vitamin K Antagonist Anticoagulants: Results From ORBIT‐AF II (The Outcomes Registry for Better Informed Treatment of Atrial Fibrillation II)
Steinberg BA, Shrader P, Pieper K, Thomas L, Allen LA, Ansell J, Chan PS, Ezekowitz MD, Fonarow GC, Freeman JV, Gersh BJ, Kowey PR, Mahaffey KW, Naccarelli GV, Reiffel JA, Singer DE, Peterson ED, Piccini JP, Investigators T. Frequency and Outcomes of Reduced Dose Non–Vitamin K Antagonist Anticoagulants: Results From ORBIT‐AF II (The Outcomes Registry for Better Informed Treatment of Atrial Fibrillation II). Journal Of The American Heart Association 2018, 7: e007633. PMID: 29453305, PMCID: PMC5850192, DOI: 10.1161/jaha.117.007633.Peer-Reviewed Original ResearchMeSH KeywordsAdministration, OralAgedAged, 80 and overAnticoagulantsAtrial FibrillationDrug Dosage CalculationsDrug PrescriptionsFemaleGuideline AdherenceHemorrhageHumansMaleMiddle AgedPractice Guidelines as TopicPractice Patterns, Physicians'Prospective StudiesRegistriesStrokeTime FactorsTreatment OutcomeUnited StatesConceptsDrug Administration labelingAtrial fibrillationNOAC doseAF patientsDose reductionNon-vitamin K antagonist anticoagulantsUS FoodORBIT-AF II registryInappropriate dose reductionOutcomes of patientsHigher unadjusted ratesCommunity practiceDrug Administration recommendationsNOAC dosesStandard dosingObservational registryOral anticoagulantsStroke preventionThromboembolic eventsUnadjusted ratesCertain patientsStandard doseNOACsPatterns of useRisk scoreUnderuse of Vitamin K Antagonist and Direct Oral Anticoagulants for Stroke Prevention in Patients With Atrial Fibrillation: A Contemporary Review
Hsu JC, Freeman JV. Underuse of Vitamin K Antagonist and Direct Oral Anticoagulants for Stroke Prevention in Patients With Atrial Fibrillation: A Contemporary Review. Clinical Pharmacology & Therapeutics 2018, 104: 301-310. PMID: 29328506, DOI: 10.1002/cpt.1024.Peer-Reviewed Original ResearchConceptsAtrial fibrillationStroke preventionVitamin K antagonistsDirect oral anticoagulantsNonvalvular AF patientsOral anticoagulant therapyRisk of strokeSpecial patient populationsSerious clinical problemOAC therapyK antagonistsOral anticoagulantsAnticoagulant therapyAF patientsPatient populationLeading causeClinical problemPatientsSignificant deleterious impactPreventionFibrillationTherapyContemporary reviewStrokeUnderuse
2017
Disease understanding in patients newly diagnosed with atrial fibrillation
Kaufman BG, Kim S, Pieper K, Allen LA, Gersh BJ, Naccarelli GV, Ezekowitz MD, Fonarow GC, Mahaffey KW, Singer DE, Chan PS, Freeman JV, Ansell J, Kowey PR, Rieffel JA, Piccini J, Peterson E, O'Brien EC. Disease understanding in patients newly diagnosed with atrial fibrillation. Heart 2017, 104: 494. PMID: 28790169, PMCID: PMC5861387, DOI: 10.1136/heartjnl-2017-311800.Peer-Reviewed Original ResearchConceptsNew-onset atrial fibrillationDirect oral anticoagulantsAtrial fibrillationOral anticoagulantsDisease understandingAtrial Fibrillation II registryNational Outcomes RegistryOngoing patient educationSubstudy of patientsHalf of patientsTreatment-naïve patientsAtrial appendage closureBetter Informed TreatmentTime of diagnosisBaseline survey responsesAppendage closureClinic visitsOutcomes RegistryRhythm controlTherapeutic optionsTreatment receiptMedical historyPatient educationPatient understandingRhythm therapyOral anticoagulation management in patients with atrial fibrillation undergoing cardiac implantable electronic device implantation
Black‐Maier E, Kim S, Steinberg BA, Fonarow GC, Freeman JV, Kowey PR, Ansell J, Gersh BJ, Mahaffey KW, Naccarelli G, Hylek EM, Go AS, Peterson ED, Piccini JP, Investigators F. Oral anticoagulation management in patients with atrial fibrillation undergoing cardiac implantable electronic device implantation. Clinical Cardiology 2017, 40: 746-751. PMID: 28543401, PMCID: PMC5638096, DOI: 10.1002/clc.22726.Peer-Reviewed Original ResearchMeSH KeywordsAdministration, OralAgedAged, 80 and overAnticoagulantsAtrial FibrillationCardiac Pacing, ArtificialCardiac Resynchronization TherapyCardiac Resynchronization Therapy DevicesDefibrillators, ImplantableDrug Administration ScheduleDrug SubstitutionElectric CountershockFemaleHemorrhageHumansMaleMiddle AgedPacemaker, ArtificialRegistriesRisk FactorsStrokeTime FactorsTreatment OutcomeConceptsCardiac implantable electronic device implantationCIED implantationNOAC patientsAnticoagulation managementAF patientsAtrial fibrillationDevice implantationOral anticoagulation managementHigher creatinine clearanceManagement of anticoagulationOral anticoagulation therapyBetter Informed TreatmentOral anticoagulant therapyAtrial fibrillation patientsValvular heart diseaseBridging anticoagulationConcomitant aspirinInterrupted warfarinOAC therapyAnticoagulation strategiesAnticoagulation therapyOral anticoagulantsPeriprocedural riskAdverse eventsAnticoagulant therapy