2022
Residual stroke risk despite oral anticoagulation in patients with atrial fibrillation
Carlisle M, Shrader P, Fudim M, Pieper K, Blanco R, Fonarow G, Naccarelli G, Gersh B, Reiffel J, Kowey P, Steinberg B, Freeman J, Ezekowitz M, Singer D, Allen L, Chan P, Pokorney S, Peterson E, Piccini J, Patients and Investigators O. Residual stroke risk despite oral anticoagulation in patients with atrial fibrillation. Heart Rhythm O2 2022, 3: 621-628. PMID: 36589908, PMCID: PMC9795305, DOI: 10.1016/j.hroo.2022.09.018.Peer-Reviewed Original ResearchTransient ischemic attackPermanent atrial fibrillationOral anticoagulationAtrial fibrillationVASc scoreIschemic attackThromboembolic eventsFemale sexPrevious stroke/transient ischemic attackStroke/transient ischemic attackTransient ischemic attack eventsCox proportional hazard modelingResidual riskResidual stroke riskBetter Informed TreatmentRisk of thromboembolismProportional hazard modelingSystemic embolismPrevious strokeStroke riskOutcomes RegistryMean ageRisk markersOutcome eventsThromboembolismLeft 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 occlusionPatient-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 riskHeart 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 administrators
2020
Switching 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 bleeds
2018
Stroke Risk and Treatment in Patients with Atrial Fibrillation and Low CHA2DS2‐VASc Scores: Findings From the ORBIT‐AF I and II Registries
Jackson L, Kim S, Fonarow GC, Freeman JV, Gersh BJ, Go AS, Hylek EM, Kowey PR, Mahaffey KW, Singer D, Thomas L, Blanco R, Peterson ED, Piccini J, Patients and Investigators T. Stroke Risk and Treatment in Patients with Atrial Fibrillation and Low CHA2DS2‐VASc Scores: Findings From the ORBIT‐AF I and II Registries. Journal Of The American Heart Association 2018, 7: e008764. PMID: 30369317, PMCID: PMC6201408, DOI: 10.1161/jaha.118.008764.Peer-Reviewed Original ResearchConceptsOral anticoagulationAtrial fibrillationTreatment strategiesCardiology/American Heart Association guidelinesStroke/transient ischemic attackLow CHA2DS2-VASc scoreAmerican Heart Association guidelinesCHA2DS2-VASc scoreThromboembolic event rateTransient ischemic attackHeart Association guidelinesCurrent American CollegePatterns of treatmentIschemic attackVASc scoreCause mortalityStroke riskTreatment patternsAbsolute riskAssociation guidelinesStroke rateVAScAmerican CollegeLower riskPatients
2016
TREATMENT AND STROKE RISK IN LOW RISK CHA2DS2VASC ATRIAL FIBRILLATION PATIENTS: FINDINGS FROM THE ORBIT-AF REGISTRY
Jackson L, Kim S, Ansell J, Fonarow G, Freeman J, Gersh B, Go A, Hylek E, Kowey P, Mahaffey K, Singer D, Thomas L, Peterson E, Piccini J. TREATMENT AND STROKE RISK IN LOW RISK CHA2DS2VASC ATRIAL FIBRILLATION PATIENTS: FINDINGS FROM THE ORBIT-AF REGISTRY. Journal Of The American College Of Cardiology 2016, 67: 788. DOI: 10.1016/s0735-1097(16)30789-6.Peer-Reviewed Original Research