Medication adherence to rivaroxaban and dabigatran for stroke prevention in patients with non-valvular atrial fibrillation in the United States

2016 ◽  
Vol 212 ◽  
pp. 171-173 ◽  
Author(s):  
Craig I. Coleman ◽  
Muralikrishna Tangirala ◽  
Thomas Evers
Keyword(s):  
United States ◽  
Atrial Fibrillation ◽  
Medication Adherence ◽  
Stroke Prevention ◽  
The United States

scholarly journals Racial/Ethnic Disparities in Atrial Fibrillation Treatment and Outcomes among Dialysis Patients in the United States

2020 ◽  
Vol 31 (3) ◽  
pp. 637-649 ◽  
Author(s):  
Salina P. Waddy ◽  
Allen J. Solomon ◽  
Adan Z. Becerra ◽  
Julia B. Ward ◽  
Kevin E. Chan ◽  
...  
Keyword(s):  
United States ◽  
Atrial Fibrillation ◽  
Cardiovascular Disease ◽  
Stroke Prevention ◽  
Ethnic Disparities ◽  
The United States ◽  
Hemodialysis Patients ◽  
Prescription Medications ◽  
Asian Patients ◽  
Racial Ethnic

BackgroundBecause stroke prevention is a major goal in the management of ESKD hemodialysis patients with atrial fibrillation, investigating racial/ethnic disparities in stroke among such patients is important to those who could benefit from strategies to maximize preventive measures.MethodsWe used the United States Renal Data System to identify ESKD patients who initiated hemodialysis from 2006 to 2013 and then identified those with a subsequent atrial fibrillation diagnosis and Medicare Part A/B/D. Patients were followed for 1 year for all-cause stroke, mortality, prescription medications, and cardiovascular disease procedures. The survival mediational g-formula quantified the percentage of excess strokes attributable to lower use of atrial fibrillation treatments by race/ethnicity.ResultsThe study included 56,587 ESKD hemodialysis patients with atrial fibrillation. Black, white, Hispanic, and Asian patients accounted for 19%, 69%, 8%, and 3% of the population, respectively. Compared with white patients, black, Hispanic, or Asian patients were more likely to experience stroke (13%, 15%, and 16%, respectively) but less likely to fill a warfarin prescription (10%, 17%, and 28%, respectively). Warfarin prescription was associated with decreased stroke rates. Analyses suggested that equalizing the warfarin distribution to that in the white population would prevent 7%, 10%, and 12% of excess strokes among black, Hispanic, and Asian patients, respectively. We found no racial/ethnic disparities in all-cause mortality or use of cardiovascular disease procedures.ConclusionsRacial/ethnic disparities in all-cause stroke among hemodialysis patients with atrial fibrillation are partially mediated by lower use of anticoagulants among black, Hispanic, and Asian patients. The reasons for these disparities are unknown, but strategies to maximize stroke prevention in minority hemodialysis populations should be further investigated.

The Left Atrial Appendage, Including LAA Occlusion Devices Line Watchman, Amulet, and Lariat

2018 ◽  
Vol 23 (1) ◽  
pp. 70-87 ◽  
Author(s):  
Robert Deegan ◽  
Christopher R. Ellis ◽  
Jeremy M. Bennett
Keyword(s):  
United States ◽  
Atrial Fibrillation ◽  
Transesophageal Echocardiography ◽  
Stroke Prevention ◽  
Left Atrial ◽  
Stroke Risk ◽  
Left Atrial Appendage ◽  
The United States ◽  
Atrial Appendage ◽  
Alternative Strategies

Atrial fibrillation is a very common arrhythmia whose prevalence is expected to increase significantly as the population ages. The associated stroke risk is a major cause of morbidity and mortality. Stroke prevention by anticoagulation carries its own risks, leading to the search for alternative strategies. Multiple techniques have been developed to exclude the left atrial appendage (the main source of thromboembolism in atrial fibrillation) from the circulation. Such techniques offer the hope of stroke prevention without the risks of anticoagulation. This article describes the percutaneous approaches being currently performed in the United States. Particular emphasis is placed on the use of transesophageal echocardiography to guide these procedures.

scholarly journals Patients' Perceptions of Atrial Fibrillation, Stroke Risk, and Oral Anticoagulation Treatment: An International Survey

TH Open ◽  
2018 ◽  
Vol 02 (03) ◽  
pp. e233-e241 ◽  
Author(s):  
Deirdre Lane ◽  
Juliane Meyerhoff ◽  
Ute Rohner ◽  
Gregory Lip
Keyword(s):  
United States ◽  
Atrial Fibrillation ◽  
Oral Anticoagulation ◽  
Stroke Prevention ◽  
Japanese Patients ◽  
The United States ◽  
Treatment Decisions ◽  
Recent Experience ◽  
Cross Sectional Survey ◽  
Country Specific

Background Global differences exist in the management of atrial fibrillation (AF), and cultural differences may influence patients' expectations and perceptions of healthcare. This survey investigated whether country-specific differences in patients' perceptions of AF and oral anticoagulation (OAC) exist and if recent stroke influences these perceptions. Methods Cross-sectional survey of 937 adults with nonvalvular AF receiving OAC for stroke prevention was conducted across United States, Canada, Germany, France, and Japan. Thirty-minute online interviews conducted between April and November 2015 included AF patients with recent stroke, and newly diagnosed AF and established AF, both without recent stroke. Results U.S. patients and those with recent stroke perceived AF as more serious (54.0 and 55.2%, respectively) and were more concerned about stroke (50.0 and 68.0%, respectively). Japanese patients were more likely to perceive AF as not serious (41.0%), but 50.4% were frequently concerned about stroke. Patients in the United States, Canada, and Germany and those without recent stroke preferred to be involved in OAC treatment decisions (either shared decision making or patient's choice), while French and Japanese patients and those with recent stroke preferred their doctor to choose. For all country groups, stroke prevention was the most important factor when choosing OAC. Conclusion In this international cohort of AF patients, country-specific differences exist in patients' perceptions of AF, concerns about stroke, and preference for involvement in OAC treatment decisions; recent experience of stroke significantly influenced patients' values and preferences regarding AF and treatment. Stroke prevention was rated as the most important factor when choosing OAC treatment.

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