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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
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1 to 3 of 3 Research Studies DisplayedAmin AP, Rao SV, Seto AH
Transradial access for high-risk percutaneous coronary intervention: implications of the risk-treatment paradox.
The study’s objective was to examine whether the association between transradial percutaneous coronary intervention (PCI; TRI) use versus transfemoral PCI (TFI) and in-hospital outcomes is influenced by baseline risk. TRI was found to reduce adverse outcomes when compared with TFI. The authors analyzed 28,005 PCIs performed in a 7-hospital system between July 2009 and April 2018. TRI use increased over time. However a risk-treatment paradox for TRI use was observed not only for bleeding risk, but for acute kidney injury (AKI) and death. The absolute risk difference between TRI and TFI increased with increasing baseline risk.
AHRQ-funded; HS022481.
Citation: Amin AP, Rao SV, Seto AH .
Transradial access for high-risk percutaneous coronary intervention: implications of the risk-treatment paradox.
Circ Cardiovasc Interv 2021 Jul;14(7):e009328. doi: 10.1161/circinterventions.120.009328..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Adverse Events, Outcomes, Patient-Centered Outcomes Research
Feng Y, Pai CW, Seiler K
Adverse outcomes associated with inappropriate direct oral anticoagulant starter pack prescription among patients with atrial fibrillation: a retrospective claims-based study.
This retrospective analysis investigated the risk for bleeding events with higher dosing of direct oral anticoagulant (DOAC) in the first 1-3 weeks of treatment for patients with atrial fibrillation (AF). Findings showed that patients who received an inappropriate DOAC prescription were more likely to identify as Black. Rates of ED visits, hospitalizations, and deaths overall were numerically lower in patients with starter pack DOAC prescriptions. In contrast, rates of ED visits and hospitalizations related to significant bleeding were numerically higher in patients with starter pack DOAC prescriptions. Among patients with AF but without acute venous thromboembolism, those who received an inappropriate DOAC starter pack had numerically higher rates of severe bleeding leading to ED visits and hospitalizations compared to those prescribed an appropriate non-starter pack DOAC anticoagulant.
AHRQ-funded; HS026874.
Citation: Feng Y, Pai CW, Seiler K .
Adverse outcomes associated with inappropriate direct oral anticoagulant starter pack prescription among patients with atrial fibrillation: a retrospective claims-based study.
J Thromb Thrombolysis 2021 May;51(4):1144-49. doi: 10.1007/s11239-020-02358-3..
Keywords: Blood Thinners, Medication, Medication: Safety, Medical Errors, Adverse Drug Events (ADE), Adverse Events, Heart Disease and Health, Cardiovascular Conditions
Axley J, Novak Z, Blakeslee-Carter J
Long-term trends in preoperative cardiac evaluation and myocardial infarction after elective vascular procedures.
This retrospective cohort study was performed using data on elective vascular surgery procedures and evaluated long-term trends in post-operative myocardial infarction (POMI) using Vascular Surgery Vascular Quality Initiative (VQI) registry data for patients undergoing carotid endarterectomy (CEA), thoracic endovascular aortic repair (TEVAR), endovascular aortic repair (EVAR), open abdominal aortic aneurysm repair (oAAA), suprainguinal bypass (SIB), and infrainguinal bypass (IIB). A total of 227,837 elective procedures were identified. The overall rate of POMI was 1.3% across all procedures. POMI rates from 2003-05 to 2015-17 for CEA decreased from 0.9% to 0.7%, EVAR from 2% to 7%, IIB from 3.8% to 2.4%, and oAAA from 6.8% to 5.1%. From 2009 to 2017 SIB decreased from 3.06% to 2.95%. However, TEVAR increased from 2.4% to 3.56% for the period 2006 to 2017. CEA, EVAR, IIB, oAAA all showed a significant increase in postoperative statin use.
AHRQ-funded; HS013852.
Citation: Axley J, Novak Z, Blakeslee-Carter J .
Long-term trends in preoperative cardiac evaluation and myocardial infarction after elective vascular procedures.
Ann Vasc Surg 2021 Feb;71:19-28. doi: 10.1016/j.avsg.2020.09.006..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Surgery, Adverse Events, Registries