Faculty

Brian F. Gage, MD, MSc

Brian F. Gage, MD, MSc is an internist and health service researcher who specializes in two related fields: antithrombotic therapy and stroke prophylaxis. He studies the real-world outcomes of antithrombotic therapy in elderly patients who have atrial fibrillation (AF). He has found that elderly Medicare beneficiaries with AF receive antithrombotic therapy infrequently, but that the absolute benefit of prescribing antithrombotic therapy to this population is similar to the benefits reported in younger patients. He has derived a clinical prediction took, CHADS2 , that predicts stroke in the Medicare AF population.

To translate these results into practice, he founded and now manages two anticoagulation clinics: (1) the Barnes-Jewish Blood Thinner Clinic, which serves clinic patients at Barnes-Jewish Hospital north, and (2) the BJC-WUPN Anticoagulation Service that serves half of the anticoagulated GHP/Advantra population. The other half of that population serves as the control group in a clinical trial. In that trial, he and his collaborators have found that the telephone-based Anticoagulation Service improves patient and physician satisfaction while reducing thrombotic and hemorrhagic adverse events. In the future, they will be recruiting patients from these two clinics for a new study that will quantify how polymorphisms in the cytochrome P450 enzyme affect warfarin dose requirements.

Letters, Book Chapters, and Invited Manuscripts

1. Gage BF, Cardinalli AB, Albers GW, Owens DK. Cost effectiveness of stroke prophylaxis for nonvalvular atrial fibrillation-Reply. JAMA 1996; 275: 910.

2. Gage BF, Lin TL. Antithrombotic Therapy and Atrial Fibrillation. In: Spandorfer J, Konkle B, Merli G, eds. Prevention and Treatment of Thrombosis in Primary Care. London: Arnold 2001:262-283.

3. Yusen RD, Haraden BM, Gage BF, Rubin BG, Botney MD. Outpatient treatment of deep venous thrombosis-Reply. Chest 1999; 116:1492-3.

4. Gage BF. Adverse outcomes and predictors of underuse of antithrombotic therapy in Medicare beneficiaries with chronic atrial fibrillation-Response. Stroke 2000; 31:2266-7.

5. Gage BF, Fihn SD, White RH. Seasonal control of warfarin therapy [Response]. American Journal of Medicine 2001; 111:332.

6. Gage BF, Yusen RD. Antithrombotic Therapy and Vascular Disease. In: Lin T, Rypkema S. The Washington Manual of Ambulatory Therapeutics. Lippincott-Raven. Philadelphia 2002.

7. Milligan PE, Banet GA, Gage BF. Peri-operative reduction of the warfarin dose [research letter]. American Journal of Medicine 2003; 115:741-742.

8. Gage BF. Randomized trial of warfarin nomograns [letter]. Annals of Internal Medicine 2004; 140:498.

9. Gage BF, Evanoff B. Clinical Epidemiology [appendix]. In The Washington Manual of Therapeutics. Lippincott-Raven. Philadelphia 2004; 678-681.

10. Gage BF. Observational Study Designs [Chapter 7]. In Clinical Science: Principles of Translational and Experimental Medicine. Edited by D. Schuster and W. Powers. Lippincott-Williams & Wilkins. Philadelphia; 2005.

11. O'Brien CL, Gage BF. Cost and effectiveness of ximelagatran for stroke prophylaxis in chronic atrial fibrillation [Response]. Journal of the American Medical Association 2005; 293:2861.

12. Gage BF, van Walraven C, Pearce L, Hart RG, Koudstaal PJ, Boode BSP, Petersen P. Selecting patients with atrial fibrillation for anticoagulation [Response].Circulation 2005 (in press).

Division of General Medical Sciences
Department of Medicine
Washington University School of Medicine