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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.

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1 to 6 of 6 Research Studies Displayed
Meng T, Trickey AM, Harris AHS
Lessons learned from the historical trends on thrombolysis use for acute ischemic stroke among Medicare beneficiaries in the United States.
The authors’ objectives were to assess and validate the change in intravenous thrombolysis (IVT) utilization in a national sample of Medicare beneficiaries and to examine the effect of patient, stroke center designation, and geography on IVT utilization. They found that, between 2007 and 2014, the frequency of IVT for patients with acute ischemic stroke increased substantially, though differences persisted in the form of less frequent treatment associated with certain characteristics.
AHRQ-funded; HS026207.
Citation: Meng T, Trickey AM, Harris AHS . Lessons learned from the historical trends on thrombolysis use for acute ischemic stroke among Medicare beneficiaries in the United States. Front Neurol 2022 Mar 4;13:827965. doi: 10.3389/fneur.2022.827965..
View abstract on the National Library of Medicine site.
Keywords: Stroke, Cardiovascular Conditions, Blood Thinners
Jackson LR, Kim S, Blanco R
Discontinuation rates of warfarin versus direct acting oral anticoagulants in US clinical practice: results from Outcomes Registry for Better Informed Treatment of Atrial Fibrillation II (ORBIT-AF II).
The objective of this study was to evaluate discontinuation rates among patients on warfarin and direct oral anticoagulants (DOACs) in clinical practice. Over 10,000 AF patients were enrolled from the ORBIT-AF II Registry as subjects. Findings showed that, in a community based atrial fibrillation cohort, adjusted rates of discontinuation at 12 months were higher in DOAC-treated versus vitamin K antagonist-treated patients. Discontinuation of oral anticoagulation was associated with increased absolute risk of all-cause mortality and cardiovascular death.
AHRQ-funded; HS021092.
Citation: Jackson LR, Kim S, Blanco R . Discontinuation rates of warfarin versus direct acting oral anticoagulants in US clinical practice: results from Outcomes Registry for Better Informed Treatment of Atrial Fibrillation II (ORBIT-AF II). Am Heart J 2020 Aug;226:85-93. doi: 10.1016/j.ahj.2020.04.016..
View abstract on the National Library of Medicine site.
Keywords: Blood Thinners, Medication, Registries, Stroke, Heart Disease and Health, Cardiovascular Conditions, Outcomes
Brand-McCarthy SR, Delaney RK, Noseworthy PA
Can shared decision making improve stroke prevention in atrial fibrillation?: Implications of the updated guidelines.
This paper discusses the need for shared decision making (SDM) in atrial fibrillation (AF) patients not just at the beginning of treatment but throughout during ongoing care. Use of SDM can help with patient adherence to recommended anticoagulation treatment regimens and lifestyle changes. It can help build a strong partnership between clinician and patient.
AHRQ-funded; HS026379.
Citation: Brand-McCarthy SR, Delaney RK, Noseworthy PA . Can shared decision making improve stroke prevention in atrial fibrillation?: Implications of the updated guidelines. Circ Cardiovasc Qual Outcomes 2020 Mar;13(3):e006080. doi: 10.1161/circoutcomes.119.006080..
View abstract on the National Library of Medicine site.
Keywords: Decision Making, Stroke, Heart Disease and Health, Cardiovascular Conditions, Prevention, Guidelines, Blood Thinners, Medication, Clinician-Patient Communication, Communication
Borre ED, Goode A, Raitz G
Predicting thromboembolic and bleeding event risk in patients with non-valvular atrial fibrillation: a systematic review.
This systematic review compared the strength of tools to predict stroke and bleeding risk in patients with atrial fibrillation (AF) taking blood thinners. Sixty-one studies were found to predict thromboembolic risk and 38 to predict bleeding risk.
AHRQ-funded; 290201500004I.
Citation: Borre ED, Goode A, Raitz G . Predicting thromboembolic and bleeding event risk in patients with non-valvular atrial fibrillation: a systematic review. Thromb Haemost 2018 Dec;118(12):2171-87. doi: 10.1055/s-0038-1675400..
View abstract on the National Library of Medicine site.
Keywords: Heart Disease and Health, Cardiovascular Conditions, Stroke, Blood Clots, Blood Thinners, Medication, Adverse Drug Events (ADE), Adverse Events, Risk, Patient-Centered Outcomes Research, Evidence-Based Practice
Desai RJ, Wyss R, Jin Y
Extension of disease risk score-based confounding adjustments for multiple outcomes of interest: an empirical evaluation.
Use of disease risk score (DRS)-based confounding adjustment when estimating treatment effects on multiple outcomes is not well studied. In this empirical cohort study, the investigators compared dabigatran initiators and warfarin initiators with respect to risks of ischemic stroke and major bleeding in 12 sequential monitoring periods (90 days each), using data from the Truven Marketscan database (Truven Health Analytics, Ann Arbor, Michigan).
AHRQ-funded; HS022193.
Citation: Desai RJ, Wyss R, Jin Y . Extension of disease risk score-based confounding adjustments for multiple outcomes of interest: an empirical evaluation. Am J Epidemiol 2018 Nov;187(11):2439-48. doi: 10.1093/aje/kwy130.
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View abstract on the National Library of Medicine site.
Keywords: Blood Thinners, Cardiovascular Conditions, Medication, Outcomes, Research Methodologies, Risk, Stroke
Lauffenburger JC, Farley JF, Gehi AK
Effectiveness and safety of dabigatran and warfarin in real-world US patients with non-valvular atrial fibrillation: a retrospective cohort study.
The researchers compared the effectiveness and safety of the new oral anticoagulant, dabigatran, with warfarin in clinical practice among a large nationally representative retrospective cohort of commercially insured patients in the United States. They found that compared with warfarin, dabigatran was associated with a lower risk of ischemic stroke or systemic embolism, hemorrhagic stroke, and acute myocardial infarction.
AHRQ-funded; HS023099.
Citation: Lauffenburger JC, Farley JF, Gehi AK . Effectiveness and safety of dabigatran and warfarin in real-world US patients with non-valvular atrial fibrillation: a retrospective cohort study. J Am Heart Assoc 2015 Apr 10;4(4):e001798. doi: 10.1161/jaha.115.001798..
View abstract on the National Library of Medicine site.
Keywords: Comparative Effectiveness, Blood Thinners, Patient-Centered Outcomes Research, Stroke, Heart Disease and Health

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