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http://dx.doi.org/10.1016/j.xjtc.2021.05.003 | DOI Listing |
J Med Econ
September 2025
Health Economics and Outcomes Research Ltd., Cardiff, United Kingdom.
Background: Medicare plans employ drug utilization management strategies, including prior authorization (PA) and step therapy (ST), or formulary tier increases, to control spending. However, PA and ST can delay treatment access and encourage use of less effective/safe therapies, while formulary tier increases can lead to treatment switching/discontinuation due to higher patient out-of-pocket costs. This study modeled the impact of restricted access to direct oral anticoagulants (DOACs), and a tier increase for apixaban, on incidence and cost of clinical events in patients with non-valvular atrial fibrillation (NVAF) in the United States.
View Article and Find Full Text PDFHeartRhythm Case Rep
August 2025
Department of Cardiovascular Medicine, The University of Kansas Medical Center, Kansas City, Kansas.
Intern Med
August 2025
Department of Cardiology, Tachikawa General Hospital, Japan.
Objective Sacubitril/valsartan combines the effects of angiotensin receptor blockers (ARBs) with increased atrial natriuretic peptide (ANP) levels through neprilysin inhibition. ANP has vasodilatory and natriuretic effects. ARB efficacy is diminished by high daily salt intake (HDSI) in hypertension; however, it is unclear whether HDSI similarly affects the efficacy of sacubitril/valsartan.
View Article and Find Full Text PDFCirc Cardiovasc Qual Outcomes
August 2025
Harvard Medical School, Boston, MA (D.H.K., D.K., D.E.S., K.J.L.).
Background: The benefits of switching from warfarin to direct oral anticoagulants in atrial fibrillation remain unclear.
Methods: This retrospective study used the Medicare fee-for-service (2013-2020) and Optum Deidentified Clinformatics Data Mart databases (2013-2023). Among patients with atrial fibrillation who received warfarin for at least 180 days, we created 2 cohorts: (1) patients switching to apixaban versus continuing warfarin (the apixaban cohort) and (2) patients switching to rivaroxaban versus continuing warfarin (the rivaroxaban cohort).
J Interv Card Electrophysiol
August 2025
Division of Cardiology, Department of Medicine, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
Background: Mitral isthmus block (MIB) complicating radiofrequency ablation (RFA) of orthodromic reciprocating tachycardia (ORT) using left - sided accessory pathways (APs) is poorly understood.
Methods: Two cases and a systematic review of the literature of patients (pts) who developed MIB complicating left - sided ORT RFA is presented.
Results: Among 27 pts (34 ± 12 years old, 54% female, 68% concealed AP), 15 (56%) had ≥ 1 failed RFA procedure.