Stroke Prevention for Atrial Fibrillation with Multiple Chronic Conditions
Rapid Secondary Analysis to Optimize Care for Patients with Multiple Chronic Conditions –R01 Grants
Principal Investigator: Vaughan Sarrazin, M.
Institution/Partners: University of Iowa
Project Period: 09/01/14--02/29/16
Grant Number: R01 HS023104-01
Description
Atrial fibrillation (AF) is a serious disturbance in cardiac rhythm that increases the risk of stroke up to fivefold. Clinical guidelines therefore recommend anticoagulant medications for many patients with AF. While stroke risk increases with age, the high prevalence of chronic conditions in the elderly can also increase the risks associated with anticoagulation. To date, there is very little data to guide choice of anticoagulant in patients with AF and multiple chronic conditions (MCC), particularly given the availability of new anticoagulants since 2010. This study will evaluate the risks and benefits of anticoagulation by warfarin, dabigatran, or rivaroxaban in patients with AF who also have MCC.
Specific Aims
- Assess the prevalence and burden of MCC among elderly patients with AF.
- Assess variations in warfarin, dabigatran, or rivaroxoban use for stroke prevention in patients with low, moderate, and high levels of MCC-related illness burden overall and by risk of stroke, bleeding, or death.
- Determine the relative likelihood of stroke, bleeding, or death for patients taking dabigatran, rivaroxaban, or warfarin, overall and within patient subsets defined by stroke risk, bleeding risk, and illness burden
Main Objective
Evaluate the risks and benefits of anticoagulation by warfarin, dabigatran, or rivaroxaban in patients with AF who also have MCC
Chronic Conditions Considered
Not specified
Study Design, Data Sources & Sample Size
Centers for Medicare and Medicaid Services (CMS)
Strategies Addressed from the HHS Strategic Framework on Multiple Chronic Conditions
- 4.B. Understand the epidemiology of multiple chronic conditions.
- 4.C. Increase clinical health research.
