IMPORTANCIA DE LA NUTRICIÓN EN EL PLAN DE ESTUDIOS DE ENFERMERÍA DE LA FESI UNAM

Introduction: In Mexico there are some regions with starvation and undernourishment, therefore the medical research has to be increased. The Nursing Major program at Facultad de Estudios Superiores Iztacala of Universidad Nacional Autónoma de México (2006) includes the study of nutrition. This one is divided in different modules but not as an specific subject, however we have observed that students are not able to incorporate all the nutrition fundamental aspects. Currently the basic theory of nutrition takes 56 hours and 50 minutes, but this one is included such as a section in different courses. “Nutrition and Health care” is an elective subject and it takes 80 hours, nevertheless there are two disadvantages. The first one is that students are allowed to take it up to the fourth semester, and the second one is that there is a lack of time (23 hours), since nutrition is a wide topic. We need to get qualified people related to this topic in order to teach efficiently. We have noticed that students need to learn more about nutrition, for that reason it is necessary to assign the nutrition topic as a compulsory subject, otherwise not all the students will be able to take the course. Material and Method: Qualitative and quantitative methods were used for the current research. For the quantitative method was used a nominal scale that allowed to sort the 34 programs reviewed from mexican institutions which have the nursing major. Two researches (done by the students) were considerated to find out that only 70% of students enrolled in seventh semester had taken the nutrition subject. Regarding the qualitative method, 10 students proposed that nutrition must be included as a compulsory subject. Results: There was a study focused on the nursing major programs from mexican universities, in which 34 was the number of programs reviewed. 28 universities have already included nutrition topic in their programs and 6 universities have not considered this matter in their programs yet. According to the results from the qualitative research, nutrition must be considered as an essential subject on the programs. Discussion: As a result of a quantitative and qualitative research, it is important to take into account, in the next evaluation of the subject’s curriculum, the opportunity to reincorporate the nutrition topic in basic semesters, and emphasize this point on all the study programs. Conclusion: In an effort to improve the topics related to nutrition and health care, it is very important to reorganize and focus on study plans at Iztacala University.Introducción: México tiene algunas regiones con hambre y desnutrición. También la producción en investigación clínica en México se debe incrementar. El Plan de Estudios de la Licenciatura en Enfermería de la Facultad de Estudios Superiores Iztacala de la Universidad Nacional Autónoma de México (2006) sí contempla el estudio de la Nutrición pero de manera fraccionada en diferentes módulos. Hemos observado que las y los estudiantes no han integrado todos los aspectos fundamentales de Nutrición. El tiempo empleado para abordar la temática teórica básica sobre Nutrición es de 56 horas con 50 minutos. Como optativa de “Nutrición y Salud” se imparten 80 horas. El primer inconveniente es que la optativa la pueden llevar hasta el 4° semestre; el segundo, es que hay un déficit de 23 horas de trabajo en el aula, si restamos las horas asignadas al módulo optativo con respecto a las horas de trabajo en los módulos obligatorios. Si México tiene problemas de nutrición, necesitamos contar con personal preparado en el tema. Vemos que no estamos aportándoles suficientemente estas herramientas, por lo que es necesario que no se estudie en forma de materia optativa, porque no todos los estudiantes la van a cursar. Material y Método: Es una investigación evaluativa cuanti-cualitativa. La parte cuantitativa empleó el nivel de escala nominal que permitió clasificar los 34 programas revisados de Instituciones de Educación Superior que imparten la Licenciatura en Enfermería en México. Se tomaron en cuenta los resultados de 2 investigaciones realizadas por estudiantes que encontraron que sólo el 70% de la matrícula de séptimo semestre han llevado Nutrición. En la parte cualitativa, 10 estudiantes sugirieron que Nutrición fuera un módulo obligatorio. Resultados: 28 Programas de los 34 revisados de Universidades de México SÍ tienen especificado en su Plan de Estudios el abordaje de Nutrición. Mientras que 6 Programas de los 34 revisados NO tienen especificado en su Plan de Estudios el abordaje de Nutrición. Los resultados cualitativos fueron constantes en cuanto a que “la optativa de Nutrición debería pasar a módulo obligatorio”. Discusión: Hay un peso cuantitativo y cualitativo que se pronuncia hacia revisar en una próxima Evaluación Curricular, la pertinencia de reincorporar en los primeros semestres obligatorios la temática de Nutrición de un manera más explícita en nuestro Plan de Estudios. Conclusión: Hay que reorganizar los contenidos programáticos en materia de Nutrición y Salud dentro de nuestro Plan de Estudios

Why Are Outcomes Different for Registry Patients Enrolled Prospectively and Retrospectively? Insights from the Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF).

Background: Retrospective and prospective observational studies are designed to reflect real-world evidence on clinical practice, but can yield conflicting results. The GARFIELD-AF Registry includes both methods of enrolment and allows analysis of differences in patient characteristics and outcomes that may result. Methods and Results: Patients with atrial fibrillation (AF) and ≥1 risk factor for stroke at diagnosis of AF were recruited either retrospectively (n = 5069) or prospectively (n = 5501) from 19 countries and then followed prospectively. The retrospectively enrolled cohort comprised patients with established AF (for a least 6, and up to 24 months before enrolment), who were identified retrospectively (and baseline and partial follow-up data were collected from the emedical records) and then followed prospectively between 0-18 months (such that the total time of follow-up was 24 months; data collection Dec-2009 and Oct-2010). In the prospectively enrolled cohort, patients with newly diagnosed AF (≤6 weeks after diagnosis) were recruited between Mar-2010 and Oct-2011 and were followed for 24 months after enrolment. Differences between the cohorts were observed in clinical characteristics, including type of AF, stroke prevention strategies, and event rates. More patients in the retrospectively identified cohort received vitamin K antagonists (62.1% vs. 53.2%) and fewer received non-vitamin K oral anticoagulants (1.8% vs . 4.2%). All-cause mortality rates per 100 person-years during the prospective follow-up (starting the first study visit up to 1 year) were significantly lower in the retrospective than prospectively identified cohort (3.04 [95% CI 2.51 to 3.67] vs . 4.05 [95% CI 3.53 to 4.63]; p = 0.016). Conclusions: Interpretations of data from registries that aim to evaluate the characteristics and outcomes of patients with AF must take account of differences in registry design and the impact of recall bias and survivorship bias that is incurred with retrospective enrolment. Clinical Trial Registration: - URL: http://www.clinicaltrials.gov . Unique identifier for GARFIELD-AF (NCT01090362)

Improved risk stratification of patients with atrial fibrillation: an integrated GARFIELD-AF tool for the prediction of mortality, stroke and bleed in patients with and without anticoagulation.

OBJECTIVES: To provide an accurate, web-based tool for stratifying patients with atrial fibrillation to facilitate decisions on the potential benefits/risks of anticoagulation, based on mortality, stroke and bleeding risks. DESIGN: The new tool was developed, using stepwise regression, for all and then applied to lower risk patients. C-statistics were compared with CHA2DS2-VASc using 30-fold cross-validation to control for overfitting. External validation was undertaken in an independent dataset, Outcome Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF). PARTICIPANTS: Data from 39 898 patients enrolled in the prospective GARFIELD-AF registry provided the basis for deriving and validating an integrated risk tool to predict stroke risk, mortality and bleeding risk. RESULTS: The discriminatory value of the GARFIELD-AF risk model was superior to CHA2DS2-VASc for patients with or without anticoagulation. C-statistics (95% CI) for all-cause mortality, ischaemic stroke/systemic embolism and haemorrhagic stroke/major bleeding (treated patients) were: 0.77 (0.76 to 0.78), 0.69 (0.67 to 0.71) and 0.66 (0.62 to 0.69), respectively, for the GARFIELD-AF risk models, and 0.66 (0.64-0.67), 0.64 (0.61-0.66) and 0.64 (0.61-0.68), respectively, for CHA2DS2-VASc (or HAS-BLED for bleeding). In very low to low risk patients (CHA2DS2-VASc 0 or 1 (men) and 1 or 2 (women)), the CHA2DS2-VASc and HAS-BLED (for bleeding) scores offered weak discriminatory value for mortality, stroke/systemic embolism and major bleeding. C-statistics for the GARFIELD-AF risk tool were 0.69 (0.64 to 0.75), 0.65 (0.56 to 0.73) and 0.60 (0.47 to 0.73) for each end point, respectively, versus 0.50 (0.45 to 0.55), 0.59 (0.50 to 0.67) and 0.55 (0.53 to 0.56) for CHA2DS2-VASc (or HAS-BLED for bleeding). Upon validation in the ORBIT-AF population, C-statistics showed that the GARFIELD-AF risk tool was effective for predicting 1-year all-cause mortality using the full and simplified model for all-cause mortality: C-statistics 0.75 (0.73 to 0.77) and 0.75 (0.73 to 0.77), respectively, and for predicting for any stroke or systemic embolism over 1 year, C-statistics 0.68 (0.62 to 0.74). CONCLUSIONS: Performance of the GARFIELD-AF risk tool was superior to CHA2DS2-VASc in predicting stroke and mortality and superior to HAS-BLED for bleeding, overall and in lower risk patients. The GARFIELD-AF tool has the potential for incorporation in routine electronic systems, and for the first time, permits simultaneous evaluation of ischaemic stroke, mortality and bleeding risks. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier for GARFIELD-AF (NCT01090362) and for ORBIT-AF (NCT01165710)

Two-year outcomes of patients with newly diagnosed atrial fibrillation: results from GARFIELD-AF.

AIMS: The relationship between outcomes and time after diagnosis for patients with non-valvular atrial fibrillation (NVAF) is poorly defined, especially beyond the first year. METHODS AND RESULTS: GARFIELD-AF is an ongoing, global observational study of adults with newly diagnosed NVAF. Two-year outcomes of 17 162 patients prospectively enrolled in GARFIELD-AF were analysed in light of baseline characteristics, risk profiles for stroke/systemic embolism (SE), and antithrombotic therapy. The mean (standard deviation) age was 69.8 (11.4) years, 43.8% were women, and the mean CHA2DS2-VASc score was 3.3 (1.6); 60.8% of patients were prescribed anticoagulant therapy with/without antiplatelet (AP) therapy, 27.4% AP monotherapy, and 11.8% no antithrombotic therapy. At 2-year follow-up, all-cause mortality, stroke/SE, and major bleeding had occurred at a rate (95% confidence interval) of 3.83 (3.62; 4.05), 1.25 (1.13; 1.38), and 0.70 (0.62; 0.81) per 100 person-years, respectively. Rates for all three major events were highest during the first 4 months. Congestive heart failure, acute coronary syndromes, sudden/unwitnessed death, malignancy, respiratory failure, and infection/sepsis accounted for 65% of all known causes of death and strokes for <10%. Anticoagulant treatment was associated with a 35% lower risk of death. CONCLUSION: The most frequent of the three major outcome measures was death, whose most common causes are not known to be significantly influenced by anticoagulation. This suggests that a more comprehensive approach to the management of NVAF may be needed to improve outcome. This could include, in addition to anticoagulation, interventions targeting modifiable, cause-specific risk factors for death. CLINICAL TRIAL REGISTRATION: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

Importance of the nutrition in the study plan of infirmary of the fesi unam

Introducción: México tiene algunas regiones con hambre y desnutrición. También la producción en investigación clínica en México se debe incrementar. El Plan de Estudios de la Licenciatura en Enfermería de la Facultad de Estudios Superiores Iztacala de la Universidad Nacional Autónoma de México (2006) sí contempla el estudio de la Nutrición pero de manera fraccionada en diferentes módulos. Hemos observado que las y los estudiantes no han integrado todos los aspectos fundamentales de Nutrición. El tiempo empleado para abordar la temática teórica básica sobre Nutrición es de 56 horas con 50 minutos. Como optativa de “Nutrición y Salud” se imparten 80 horas. El primer inconveniente es que la optativa la pueden llevar hasta el 4° semestre; el segundo, es que hay un déficit de 23 horas de trabajo en el aula, si restamos las horas asignadas al módulo optativo con respecto a las horas de trabajo en los módulos obligatorios. Si México tiene problemas de nutrición, necesitamos contar con personal preparado en el tema. Vemos que no estamos aportándoles suficientemente estas herramientas, por lo que es necesario que no se estudie en forma de materia optativa, porque no todos los estudiantes la van a cursar. Material y Método: Es una investigación evaluativa cuanti-cualitativa. La parte cuantitativa empleó el nivel de escala nominal que permitió clasificar los 34 programas revisados de Instituciones de Educación Superior que imparten la Licenciatura en Enfermería en México. Se tomaron en cuenta los resultados de 2 investigaciones realizadas por estudiantes que encontraron que sólo el 70% de la matrícula de séptimo semestre han llevado Nutrición. En la parte cualitativa, 10 estudiantes sugirieron que Nutrición fuera un módulo obligatorio. Resultados: 28 Programas de los 34 revisados de Universidades de México SÍ tienen especificado en su Plan de Estudios el abordaje de Nutrición. Mientras que 6 Programas de los 34 revisados NO tienen especificado en su Plan de Estudios el abordaje de Nutrición. Los resultados cualitativos fueron constantes en cuanto a que “la optativa de Nutrición debería pasar a módulo obligatorio”. Discusión: Hay un peso cuantitativo y cualitativo que se pronuncia hacia revisar en una próxima Evaluación Curricular, la pertinencia de reincorporar en los primeros semestres obligatorios la temática de Nutrición de un manera más explícita en nuestro Plan de Estudios. Conclusión: Hay que Enfermería Global Nº 16 Junio 2009 Página 2 reorganizar los contenidos programáticos en materia de Nutrición y Salud dentro de nuestro Plan de Estudios.ABSTRACT Introduction: In Mexico there are some regions with starvation and undernourishment, therefore the medical research has to be increased. The Nursing Major program at Facultad de Estudios Superiores Iztacala of Universidad Nacional Autónoma de México (2006) includes the study of nutrition. This one is divided in different modules but not as an specific subject, however we have observed that students are not able to incorporate all the nutrition fundamental aspects. Currently the basic theory of nutrition takes 56 hours and 50 minutes, but this one is included such as a section in different courses. “Nutrition and Health care” is an elective subject and it takes 80 hours, nevertheless there are two disadvantages. The first one is that students are allowed to take it up to the fourth semester, and the second one is that there is a lack of time (23 hours), since nutrition is a wide topic. We need to get qualified people related to this topic in order to teach efficiently. We have noticed that students need to learn more about nutrition, for that reason it is necessary to assign the nutrition topic as a compulsory subject, otherwise not all the students will be able to take the course. Material and Method: Qualitative and quantitative methods were used for the current research. For the quantitative method was used a nominal scale that allowed to sort the 34 programs reviewed from mexican institutions which have the nursing major. Two researches (done by the students) were considerated to find out that only 70% of students enrolled in seventh semester had taken the nutrition subject. Regarding the qualitative method, 10 students proposed that nutrition must be included as a compulsory subject. Results: There was a study focused on the nursing major programs from mexican universities, in which 34 was the number of programs reviewed. 28 universities have already included nutrition topic in their programs and 6 universities have not considered this matter in their programs yet. According to the results from the qualitative research, nutrition must be considered as an essential subject on the programs. Discussion: As a result of a quantitative and qualitative research, it is important to take into account, in the next evaluation of the subject’s curriculum, the opportunity to reincorporate the nutrition topic in basic semesters, and emphasize this point on all the study programs. Conclusion: In an effort to improve the topics related to nutrition and health care, it is very important to reorganize and focus on study plans at Iztacala University

Predictors of NOAC versus VKA use for stroke prevention in patients with newly diagnosed atrial fibrillation: Results from GARFIELD-AF

Introduction: A principal aim of the Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) was to document changes in treatment practice for patients with newly diagnosed atrial fibrillation during an era when non–vitamin K antagonist oral anticoagulants (NOACs) were becoming more widely adopted. In these analyses, the key factors which determined the choice between NOACs and vitamin K antagonists (VKAs) are explored. Methods: Logistic least absolute shrinkage and selection operator regression determined predictors of NOAC and VKA use. Data were collected from 24,137 patients who were initiated on AC ± antiplatelet (AP) therapy (NOAC [51.4%] or VKA [48.6%]) between April 2013 and August 2016. Results: The most significant predictors of AC therapy were country, enrolment year, care setting at diagnosis, AF type, concomitant AP, and kidney disease. Patients enrolled in emergency care or in the outpatient setting were more likely to receive a NOAC than those enrolled in hospital (OR 1.16 [95% CI: 1.04-1.30], OR: 1.15 [95% CI: 1.05-1.25], respectively). NOAC prescribing seemed to be favored in lower-risk groups, namely, patients with paroxysmal AF, normotensive patients, and those with moderate alcohol consumption, but also the elderly and patients with acute coronary syndrome. By contrast, VKAs were preferentially used in patients with permanent AF, moderate to severe kidney disease, heart failure, vascular disease, and diabetes and with concomitant AP. Conclusion: GARFIELD-AF data highlight marked heterogeneity in stroke prevention strategies globally. Physicians are adopting an individualized approach to stroke prevention where NOACs are favored in patients with a lower stroke risk but also in the elderly and patients with acute coronary syndrome

Stroke prevention in patients from Latin American countries with non-valvular atrial fibrillation: Insights from the GARFIELD-AF registry

Background: Atrial fibrillation (AF) is an important preventable cause of stroke. Anticoagulation (AC) therapy can reduce this risk. However, prescribing patterns and outcomes in patients with non-valvular AF (NVAF) from Latin American countries are poorly described. Methods: Using data from the Global Anticoagulant Registry in the FIELD-AF (GARFIELD-AF), we examined the stroke prevention strategies and the 1-year outcomes in patients from four Latin American countries: Argentina, Brazil, Chile, and Mexico. Results: A total of 4162 patients (2010-2014) were included in this analysis. At the time of AF diagnosis, 39.9% of patients were prescribed vitamin K antagonists (VKA) ± antiplatelet (AP) therapy, 21.8% non-VKA oral anticoagulant (NOAC) ± AP, 24.1% AP only and 14.1% no antithrombotic treatment. The proportion of moderate-high risk patients receiving no AC therapy at participating centers was highest in Mexico (46.4%) and lowest in Chile (14.3%). During 1-year follow-up, the rates of all-cause mortality, stroke/SE and major bleeding were: 5.77 (95% CI) (5.06-6.56), 1.58 (1.23-2.02), and 0.99 (0.72-1.36) and per 100 person-years, respectively, which are higher than the global rates across all countries in GARFIELD-AF. Unadjusted rates of all-cause mortality were highest in Argentina, 6.95 (5.43-8.90), and lowest in Chile, 4.01 (2.92-5.52). Conclusions: GARFIELD-AF results describes the marked variation in the baseline characteristics and patterns of antithrombotic treatments in patients with NVAF in four Latin American countries. Over one-third of patients with a moderate-to-high risk of stroke received no AC therapy, highlighting the need for improved management of patients according to national guideline. Clinical Trial Registration—URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

Quality of vitamin k antagonist control and 1-year outcomes in patients with atrial fibrillation: A global perspective from the GARFIELD-AF registry

Aims Vitamin K antagonists (VKAs) need to be individually dosed. International guidelines recommend a target range of international normalised ratio (INR) of 2.0-3.0 for stroke prevention in atrial fibrillation (AF). We analysed the time in this therapeutic range (TTR) of VKAtreated patients with newly diagnosed AF in the ongoing, global, observational registry GARFIELD-AF. Taking TTR as a measure of the quality of patient management, we analysed its relationship with 1-year outcomes, including stroke/systemic embolism (SE), major bleeding, and all-cause mortality. Methods and Results TTR was calculated for 9934 patients using 136,082 INR measurements during 1-year follow-up. The mean TTR was 55.0%; values were similar for different VKAs. 5851 (58.9%) patients had TTR&lt;65%; 4083 (41.1%) TTR≥65%. The proportion of patients with TTR≥65% varied from 16.7% in Asia to 49.4% in Europe. There was a 2.6-fold increase in the risk of stroke/SE, 1.5-fold increase in the risk of major bleeding, and 2.4-fold increase in the risk of all-cause mortality with TTR&lt;65% versus ≥65% after adjusting for potential confounders. The population attributable fraction, i.e. the proportion of events attributable to suboptimal anticoagulation among VKA users, was 47.7% for stroke/SE, 16.7% for major bleeding, and 45.4% for all-cause mortality. In patients with TTR&lt;65%, the risk of first stroke/SE was highest in the first 4 months and decreased thereafter (test for trend, p = 0.021). In these patients, the risk of first major bleed declined during follow-up (p = 0.005), whereas in patients with TTR≥65%, the risk increased over time (p = 0.027). Conclusion A large proportion of patients with AF had poor VKA control and these patients had higher risks of stroke/SE, major bleeding, and all-cause mortality. Our data suggest that there is room for improvement of VKA control in routine clinical practice and that this could substantially reduce adverse outcomes

Analysis of Outcomes in Ischemic vs Nonischemic Cardiomyopathy in Patients with Atrial Fibrillation: A Report from the GARFIELD-AF Registry

Importance: Congestive heart failure (CHF) is commonly associated with nonvalvular atrial fibrillation (AF), and their combination may affect treatment strategies and outcomes. Objective: To assess the treatment strategies and 1-year clinical outcomes of antithrombotic and CHF therapies for patients with newly diagnosed AF with concomitant CHF stratified by etiology (ischemic cardiomyopathy [ICM] vs nonischemic cardiomyopathy [NICM]). Design, Setting, and Participants: The GARFIELD-AF registry is a prospective, noninterventional registry. A total of 52014 patients with AF were enrolled between March 2010 and August 2016. A total of 11738 patients 18 years and older with newly diagnosed AF (≤6 weeks' duration) and at least 1 investigator-determined stroke risk factor were included. Data were analyzed from December 2017 to September 2018. Exposures: One-year follow-up rates of death, stroke/systemic embolism, and major bleeding were assessed. Main Outcomes and Measures: Event rates per 100 person-years were estimated from the Poisson model and Cox hazard ratios (HRs) and 95% confidence intervals. Results: The median age of the population was 71.0 years, 22987 of 52013 were women (44.2%) and 31958 of 52014 were white (61.4%). Of 11738 patients with CHF, 4717 (40.2%) had ICM and 7021 (59.8%) had NICM. Prescription of oral anticoagulant and antiplatelet drugs was not balanced between groups. Oral anticoagulants with or without antiplatelet drugs were used in 2753 patients with ICM (60.1%) and 5082 patients with NICM (73.7%). Antiplatelets were prescribed alone in 1576 patients with ICM (34.4%) and 1071 patients with NICM (15.5%). Compared with patients with NICM, use of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (72.6% [3439] vs 60.3% [4236]) and of β blockers (63.3% [2988] vs 53.2% [3737]) was higher in patients with ICM. Rates of all-cause and cardiovascular death per 100 patient-years were significantly higher in the ICM group (all-cause death: ICM, 10.2; 95% CI, 9.2-11.1; NICM, 7.0; 95% CI, 6.4-7.6; cardiovascular death: ICM, 5.1; 95% CI, 4.5-5.9; NICM, 2.9; 95% CI, 2.5-3.4). Stroke/systemic embolism rates tended to be higher in ICM groups compared with NICM groups (ICM, 2.0; 95% CI, 1.6-2.5; NICM, 1.5; 95% CI, 1.3-1.9). Major bleeding rates were significantly higher in the ICM group (1.1; 95% CI, 0.8-1.4) compared with the NICM group (0.7; 95% CI, 0.5-0.9). Conclusions and Relevance: Patients with ICM received oral anticoagulants with or without antiplatelet drugs less frequently and antiplatelets alone more frequently than patients with NICM, but they received angiotensin-converting enzyme inhibitors/angiotensin receptor blockers more often than patients with NICM. All-cause and cardiovascular death rates were higher in patients with ICM than patients with NICM. Trial Registration: ClinicalTrials.gov Identifier: NCT01090362