Warfarin for prevention of thromboembolism in atrial fibrillation: comparison of patient characteristics and outcomes of the “Real-World” Michigan Anticoagulation Quality Improvement Initiative (MAQI2) registry to the RE-LY, ROCKET-AF, and ARISTOTLE trials

8561 Background: Atezolizumab plus chemotherapy was the first CIT combination regimen approved for 1L treatment of ES-SCLC in 2019. This study investigated patient characteristics and treatment patterns for patients with ES-SCLC receiving this regimen in the real-world community oncology setting. Methods: This was a retrospective study including adult patients diagnosed with ES-SCLC between 01-Oct-2018 (after IMpower 133 publication in NEJM Sep-2018) and 31-Dec-2019, with follow-up through 31-March-2020 using The US Oncology Network electronic health records data. Descriptive analyses of patient characteristics and treatment patterns were conducted, with Kaplan-Meier (K-M) methods used to assess time to treatment discontinuation (TTD) and time to next treatment/death (TTNT). Results: Of the 408 patients included in this study, 267 (71.4%) received atezo+carboplatin+etoposide (Atezo+Chemo), 80 (21.4%) received carboplatin+etoposide (Chemo only) and the rest received other regimens. The Atezo+Chemo patients in the real-world cohort compared with the IMpower 133 trial (n = 201) were older (median age 68 vs. 64 years) and included fewer males (45% vs. 64%), fewer white race (73% vs. 81%), more patients with brain metastases at baseline (23% vs. 9%), and more patients with worse ECOG (2/3) performance-status score (24% vs. 0%). The median follow-up, TTD, and TTNT in months (mo) for the real-world cohort are presented in the table alongside the best comparable measures reported for the trial. Conclusions: Most patients in this real-world ES-SCLC cohort received the Atezo+Chemo regimen in the 1L setting. While the follow-up was much shorter and patients had worse baseline characteristics (age, brain metastases, ECOG) in the real-world setting compared to the IMpower 133 trial, the real-world median TTD in this descriptive analysis was found to be in line with the median duration of treatment in the trial. Further research with longer follow-up comparing the real-world effectiveness of the CIT and chemo regimens is needed.[Table: see text]

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Pulmonary vein isolation cryoablation for patients with persistent and long-standing persistent atrial fibrillation: Clinical outcomes from the real-world multicenter observational project

Heart Rhythm ◽

10.1016/j.hrthm.2017.10.038 ◽

2018 ◽

Vol 15 (3) ◽

pp. 363-368 ◽

Cited By ~ 28

Author(s):

Claudio Tondo ◽

Saverio Iacopino ◽

Paolo Pieragnoli ◽

Giulio Molon ◽

Roberto Verlato ◽

...

Keyword(s):

Atrial Fibrillation ◽

Clinical Outcomes ◽

Pulmonary Vein ◽

Pulmonary Vein Isolation ◽

Real World ◽

Persistent Atrial Fibrillation ◽

The Real

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Abstract 096: Association of Body Mass Index With Bleeding in Patients Taking Warfarin for Atrial Fibrillation or Venous Thromboembolism

Circulation Cardiovascular Quality and Outcomes ◽

10.1161/circoutcomes.10.suppl_3.096 ◽

2017 ◽

Vol 10 (suppl_3) ◽

Author(s):

Kyle Stahlbaum ◽

Eva Kline-Rogers ◽

Xiaowen Kong ◽

Geoffrey D Barnes ◽

Brian Haymart ◽

...

Keyword(s):

Atrial Fibrillation ◽

Body Mass Index ◽

Quality Improvement ◽

Venous Thromboembolism ◽

Body Mass ◽

Normal Weight ◽

Risk Scores ◽

Quality Improvement Initiative ◽

Minor Bleeding ◽

Life Threatening

Background: Most patients taking warfarin for atrial fibrillation (AF) and venous thromboembolism (VTE) have a target International Normalized Ratio (INR) between 2-3 to reduce risk of bleeding and thromboembolic events. Body Mass Index (BMI) is not included in traditional bleed risk scores, but may be an indicator of bleeding risk in warfarin patients. Methods: Using data from the multi-site Michigan Anticoagulation Quality Improvement Initiative (MAQI 2 ) Registry, we identified all AF/VTE patients , separated them into three cohorts: BMI < 20 (underweight), BMI 20-25 (normal weight) and BMI >25 (overweight). Bleeding events in these cohorts were identified and stratified into severity according to International Society of Thrombosis and Hemostasis criteria. Results: Of 6,054 patients, 4,766 (78.7%) had a BMI of > 25. These patients were generally younger, with higher prevalence of hypertension. The HAS-BLED scores were slightly lower in overweight AF patients (2.6 vs 2.8; p=0.04); otherwise no difference between groups. The overall minor, major, and life threatening bleeding rates were 22.8/27.7; 4.3/3.7; and 1.2/0.7 (per 100 patient years) in AF and VTE patients, respectively. A higher proportion of females were underweight for both indications, and AF patients were older. More underweight and normal weight AF and VTE patients had a bleeding history compared to overweight patients. Bleeding outcomes are listed in Table. Comparisons were made with Poisson regression analysis. Conclusion: In a large, unselected cohort of warfarin treated patient from a multi-site registry, minor bleeding was more common in underweight and normal weight AF patients; major and life-threatening bleeding was more common in underweight and normal weight VTE patients. Since the majority of patients were overweight, further studies are needed to determine if reasons for bleeding differ between patients based on BMI in order to guide quality improvement efforts.

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