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dc.contributor.authorKundu, Amartya
dc.contributor.authorDay, Kevin O.
dc.contributor.authorLessard, Darleen M.
dc.contributor.authorGore, Joel M.
dc.contributor.authorYu, Hong
dc.contributor.authorAkhter, Mohammed W.
dc.contributor.authorFisher, Daniel Z.
dc.contributor.authorHayward, Robert M. Jr
dc.contributor.authorHenninger, Nils
dc.contributor.authorKapoor, Alok
dc.contributor.authorYarzebski, Jorge L.
dc.contributor.authorGoldberg, Robert J.
dc.contributor.authorMcManus, David D.
dc.date2022-08-11T08:10:35.000
dc.date.accessioned2022-08-23T17:13:33Z
dc.date.available2022-08-23T17:13:33Z
dc.date.issued2018-02-28
dc.date.submitted2018-08-29
dc.identifier.citation<p>J Atr Fibrillation. 2018 Feb 28;10(5):1749. doi: 10.4022/jafib.1749. eCollection 2018 Feb. <a href="http://jafib.com/published.php?type=full&id=1749&is=previous_issue&f=full">Link to article on publisher's site</a></p>
dc.identifier.issn1941-6911 (Linking)
dc.identifier.doi10.4022/jafib.1749
dc.identifier.pmid29988239
dc.identifier.urihttp://hdl.handle.net/20.500.14038/46752
dc.description<p>Full author list omitted for brevity. For the full list of authors, see article.</p>
dc.description.abstractBackground: Atrial fibrillation (AF) is a common complication of acute myocardial infarction (AMI).The CHA2DS2VAScand CHADS2risk scoresare used to identifypatients with AF at risk for strokeand to guide oral anticoagulants (OAC) use, including patients with AMI. However, the epidemiology of AF, further stratifiedaccording to patients' risk of stroke, has not been wellcharacterized among those hospitalized for AMI. Methods: We examined trends in the frequency of AF, rates of discharge OAC use, and post-discharge outcomes among 6,627 residents of the Worcester, Massachusetts area who survived hospitalization for AMI at 11 medical centers between 1997 and 2011. Results: A total of 1,050AMI patients had AF (16%) andthe majority (91%)had a CHA2DS2VAScscore > 2.AF rates were highest among patients in the highest stroke risk group.In comparison to patients without AF, patients with AMI and AF in the highest stroke risk category had higher rates of post-discharge complications, including higher 30-day re-hospitalization [27 % vs. 17 %], 30-day post-discharge death [10 % vs. 5%], and 1-year post-discharge death [46 % vs. 18 %] (p < 0.001 for all). Notably, fewer than half of guideline-eligible AF patients received an OAC prescription at discharge. Usage rates for other evidence-based therapies such as statins and beta-blockers,lagged in comparison to AMI patients free from AF. Conclusions: Our findings highlight the need to enhance efforts towards stroke prevention among AMI survivors with AF.
dc.language.isoen_US
dc.relation<p><a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=29988239&dopt=Abstract">Link to Article in PubMed</a></p>
dc.rightsJournal of Atrial Fibrillation is an open access journal according to http://jafib.com/open_access.php. The license used is the Creative Commons Attribution 2.5 Generic license.
dc.subjectAnticoagulation
dc.subjectAtrial Fibrillation
dc.subjectEpidemiology
dc.subjectOutcomes
dc.subjectCardiology
dc.subjectCardiovascular Diseases
dc.subjectClinical Epidemiology
dc.subjectEpidemiology
dc.subjectHealth Services Administration
dc.titleRecent Trends in Oral Anticoagulant Use and Post-Discharge Complications Among Atrial Fibrillation Patients with Acute Myocardial Infarction
dc.typeJournal Article
dc.source.journaltitleJournal of atrial fibrillation
dc.source.volume10
dc.source.issue5
dc.identifier.legacyfulltexthttps://escholarship.umassmed.edu/cgi/viewcontent.cgi?article=2213&amp;context=qhs_pp&amp;unstamped=1
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/qhs_pp/1212
dc.identifier.contextkey12745073
refterms.dateFOA2022-08-23T17:13:33Z
html.description.abstract<p>Background: Atrial fibrillation (AF) is a common complication of acute myocardial infarction (AMI).The CHA2DS2VAScand CHADS2risk scoresare used to identifypatients with AF at risk for strokeand to guide oral anticoagulants (OAC) use, including patients with AMI. However, the epidemiology of AF, further stratifiedaccording to patients' risk of stroke, has not been wellcharacterized among those hospitalized for AMI.</p> <p>Methods: We examined trends in the frequency of AF, rates of discharge OAC use, and post-discharge outcomes among 6,627 residents of the Worcester, Massachusetts area who survived hospitalization for AMI at 11 medical centers between 1997 and 2011.</p> <p>Results: A total of 1,050AMI patients had AF (16%) andthe majority (91%)had a CHA2DS2VAScscore > 2.AF rates were highest among patients in the highest stroke risk group.In comparison to patients without AF, patients with AMI and AF in the highest stroke risk category had higher rates of post-discharge complications, including higher 30-day re-hospitalization [27 % vs. 17 %], 30-day post-discharge death [10 % vs. 5%], and 1-year post-discharge death [46 % vs. 18 %] (p < 0.001 for all). Notably, fewer than half of guideline-eligible AF patients received an OAC prescription at discharge. Usage rates for other evidence-based therapies such as statins and beta-blockers,lagged in comparison to AMI patients free from AF.</p> <p>Conclusions: Our findings highlight the need to enhance efforts towards stroke prevention among AMI survivors with AF.</p>
dc.identifier.submissionpathqhs_pp/1212
dc.contributor.departmentDepartment of Neurology
dc.contributor.departmentDepartment of Quantitative Health Sciences
dc.contributor.departmentDepartment of Medicine, Division of Cardiovascular Medicine
dc.source.pages1749


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