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 preventionBleeding
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 ageResearch 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
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 administrators
2018
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)
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
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