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
Comparative Safety of Transcatheter LAAO With the First-Generation Watchman and Next-Generation Watchman FLX Devices
Price M, Friedman D, Du C, Wang Y, Lin Z, Curtis J, Freeman J. Comparative Safety of Transcatheter LAAO With the First-Generation Watchman and Next-Generation Watchman FLX Devices. JACC Cardiovascular Interventions 2022, 15: 2115-2123. PMID: 36357014, DOI: 10.1016/j.jcin.2022.09.002.Peer-Reviewed Original ResearchConceptsHospital major adverse eventsMajor adverse eventsWatchman FLXMajor vascular complicationsMajor bleedingPericardial effusionCardiac arrestDevice embolizationVascular complicationsMyocardial infarctionLower ratesSystemic arterial embolismComposite of deathTransient ischemic attackAtrial appendage occlusionSignificant lower rateBalance of risksHospital mortalityIschemic attackArterial embolismHospital outcomesPrimary endpointStroke preventionAdverse eventsProcedural complicationsLeft 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 occlusionHeart Rhythm Society Atrial Fibrillation Centers of Excellence Study: A survey analysis of stakeholder practices, needs, and barriers
Sandhu RK, Seiler A, Johnson CJ, Bunch TJ, Deering TF, Deneke T, Kirchhof P, Natale A, Piccini JP, Russo AM, Hills MT, Varosy PD, Araia A, Smith AM, Freeman J. Heart Rhythm Society Atrial Fibrillation Centers of Excellence Study: A survey analysis of stakeholder practices, needs, and barriers. Heart Rhythm 2022, 19: 1039-1048. PMID: 35428582, DOI: 10.1016/j.hrthm.2022.02.022.Peer-Reviewed Original ResearchConceptsStroke preventionHeart failure preventionAF-related complicationsPatient-centered approachTask ForceAdvanced practice professionalsHealth care systemAF careModifiable causesStroke riskEmergency departmentCare pathwayMajor unmetInpatient settingTreatment statusPatientsCare deliveryFrequent barriersOrder setsCare systemStandardized protocolCommon barriersComprehensive questionnairePreventionHospital administratorsClinical Outcomes at 1 Year Following Transcatheter Left Atrial Appendage Occlusion in the United States
Price MJ, Slotwiner D, Du C, Freeman JV, Turi Z, Rammohan C, Kusumoto FM, Kavinsky C, Akar J, Varosy PD, Koutras C, Curtis JP, Masoudi FA. Clinical Outcomes at 1 Year Following Transcatheter Left Atrial Appendage Occlusion in the United States. JACC Cardiovascular Interventions 2022, 15: 741-750. PMID: 35393108, PMCID: PMC9116488, DOI: 10.1016/j.jcin.2022.02.009.Peer-Reviewed Original ResearchConceptsAtrial appendage occlusionIschemic strokeMajor bleedingClinical outcomesSystemic embolismAppendage occlusionMean HAS-BLED scoreHAS-BLED scoreKey secondary endpointKaplan-Meier methodCumulative event rateRate of mortalityMean CHAPrior strokeRelevant bleedingVASc scoreWATCHMAN procedurePrimary endpointSecondary endpointsThromboembolic eventsIntracranial bleedingBlood transfusionHemoglobin levelsHemorrhagic strokeKaplan-Meier
2020
Outcomes 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 infarction
2019
Outcomes and Anticoagulation Use After Catheter Ablation for Atrial Fibrillation
Freeman JV, Shrader P, Pieper KS, Allen LA, Chan PS, Fonarow GC, Gersh BJ, Kowey PR, Mahaffey KW, Naccarelli G, Reiffel JA, Singer DE, Go AS, Hylek EM, Steinberg BA, Peterson ED, Piccini JP. Outcomes and Anticoagulation Use After Catheter Ablation for Atrial Fibrillation. Circulation Arrhythmia And Electrophysiology 2019, 12: e007612. PMID: 31830822, DOI: 10.1161/circep.119.007612.Peer-Reviewed Original ResearchConceptsAF catheter ablationOral anticoagulationRisk of strokeAF ablationCatheter ablationAntiarrhythmic medicationsDe novo AF ablationDiscontinuation of OACPropensity score-matched cohortAtrial fibrillation catheter ablationAF ablation patientsAnti-arrhythmic medicationsAtrial Fibrillation RegistryStroke prevention therapyBetter Informed TreatmentCohort of patientsPatterns of treatmentProportional hazards regressionUS national registryAnticoagulation useCause deathMajor bleedingSystemic embolismCardiovascular deathCause hospitalizationAssociation 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
B-type natriuretic peptide, disease progression and clinical outcomes in atrial fibrillation
Inohara T, Kim S, Pieper K, Blanco RG, Allen LA, Fonarow GC, Gersh BJ, Ezekowitz MD, Kowey PR, Reiffel JA, Naccarelli GV, Chan PS, Mahaffey KW, Singer DE, Freeman JV, Steinberg BA, Peterson ED, Piccini JP. B-type natriuretic peptide, disease progression and clinical outcomes in atrial fibrillation. Heart 2018, 105: 370. PMID: 30228248, DOI: 10.1136/heartjnl-2018-313642.Peer-Reviewed Original ResearchConceptsB-type natriuretic peptideAtrial fibrillationAF progressionBNP levelsMajor bleedingBNP valuesNatriuretic peptideDisease progressionAtrial Fibrillation II registryBiomarker-based risk stratificationElevated BNP valuesBetter Informed TreatmentPersistent atrial fibrillationCox frailty modelCardiovascular outcomesComposite outcomeBNP concentrationsNeurological eventsClinical outcomesOutcomes RegistryRisk stratificationPatient outcomesInformed TreatmentPatientsBleedingPrognostic 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 visitsCharacteristics and outcomes of adults with chronic obstructive pulmonary disease and atrial fibrillation
Durheim MT, Holmes DN, Blanco RG, Allen LA, Chan PS, Freeman JV, Fonarow GC, Go AS, Hylek EM, Mahaffey KW, Pokorney SD, Reiffel JA, Singer DE, Peterson ED, Piccini JP. Characteristics and outcomes of adults with chronic obstructive pulmonary disease and atrial fibrillation. Heart 2018, 104: 1850. PMID: 29875139, DOI: 10.1136/heartjnl-2017-312735.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overAnti-Arrhythmia AgentsAnticoagulantsAtrial FibrillationComorbidityFemaleHealth StatusHeart Conduction SystemHemorrhageHospitalizationHumansLungMalePrevalencePulmonary Disease, Chronic ObstructiveQuality of LifeRegistriesRisk AssessmentRisk FactorsTime FactorsTreatment OutcomeUnited StatesConceptsChronic obstructive pulmonary diseaseObstructive pulmonary diseaseAtrial fibrillationSymptom burdenHeart failurePulmonary diseaseHigh riskDiagnosis of COPDNew-onset heart failureTreatment of AFBeta-blocker useCardiovascular risk factorsMajor bleeding eventsHigh symptom burdenBetter Informed TreatmentCoronary artery diseaseOutcomes of adultsQuality of lifeBleeding eventsDigoxin useBlocker useCause mortalityProspective registryReversible causesCardiovascular mortalityFrequency 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 score
2017
Oral 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
2012
Cost-effectiveness of pharmacologic and invasive therapies for stroke prophylaxis in atrial fibrillation
Solomon MD, Ullal AJ, Hoang DD, Freeman JV, Heidenreich P, Turakhia MP. Cost-effectiveness of pharmacologic and invasive therapies for stroke prophylaxis in atrial fibrillation. Journal Of Cardiovascular Medicine 2012, 13: 86-96. PMID: 22193838, DOI: 10.2459/jcm.0b013e32834f23cf.Peer-Reviewed Original ResearchConceptsCost-effectiveness analysisAtrial fibrillationNonpharmacologic therapiesAtrial fibrillation-related strokeVitamin K antagonistsNew pharmacologic therapiesDirect thrombin inhibitorDevice-based therapiesLeft atrial appendageStroke Risk ProfileHealth policy recommendationsPercutaneous ligationStroke prophylaxisK antagonistsStroke preventionPharmacologic therapySurgical ligationAbnormal heart rhythmAntiplatelet agentsProphylaxis strategiesAtrial appendageRight atriumEndovascular implantationInvasive therapySystemic circulation
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