Medtronic Study Highlights Sex-Based Disparities In Post-Stroke Cardiac Care

Medtronic announced findings from a study highlighting significant disparities in cardiac care following stroke. The DiVERT Stroke clinical study revealed that women admitted to comprehensive stroke centers spent less time in the hospital, received fewer referrals to cardiology, and were prescribed post-stroke cardiac monitoring less frequently than men. Investigators presented these findings last week at the International Stroke Conference (ISC) in Los Angeles.

Medtronic notes that multiple studies indicate a high risk of atrial fibrillation (AFib) following a stroke, often taking more than 80 days to appear, underscoring the need for long-term insertable cardiac monitoring (ICM). While previous research has demonstrated disparities in stroke care between men and women, the company emphasizes that the full extent of these differences remains insufficiently studied.

The DiVERT Stroke study examined in-hospital care pathways for patients with cryptogenic stroke, large-vessel atherosclerotic disease, and small vessel disease stroke subtypes. A retrospective analysis of 2,699 patients found that female patients, who made up 48% of the study group, were less likely than males to receive cardiology referrals during their initial hospitalization (12.8% vs. 15.5%). Women also had a shorter hospital stay (6.8 days vs. 7.7 days) and were less likely to receive post-stroke cardiac monitoring (19.9% vs. 23%). Additionally, AFib detection rates were higher among patients who underwent any form of cardiac monitoring compared to those who did not, regardless of sex. However, the study found no significant sex-based differences in the type of cardiac monitoring used, whether external or insertable cardiac monitors.

Looking ahead, Medtronic plans to initiate Phase II of the DiVERT Stroke study to explore opportunities for improving workflow deficiencies, including referral pathways, which could help reduce disparities in care. Dr. David Z. Rose, professor of vascular neurology at the University of South Florida Morsani College of Medicine at Tampa General Hospital and lead investigator in the DiVERT Stroke study, emphasized the importance of addressing these disparities, stating, “Women have a higher lifetime risk of stroke compared to men, and yet these findings suggest that when it comes to post-stroke care, women are seeing cardiology less often and getting less cardiac monitoring care than their male counterparts. Standardizing care pathways between neurology and cardiology is one way to help ensure more stroke patients receive guideline-informed cardiac monitoring after a stroke. Further research on this topic is needed and may include artificial intelligence (AI) solutions.”