A new analysis from the DiVERT Stroke clinical study has uncovered significant gender-based disparities in post-stroke cardiac care, raising concerns about potential gaps in the treatment pathway for female patients.
The retrospective study, examining 2,699 patients at comprehensive stroke centers, found that women, who comprised 48% of participants, received markedly different care compared to their male counterparts. Female patients experienced shorter hospital stays (6.8 days versus 7.7 days) and were less likely to receive cardiology referrals during their initial hospitalization (12.8% versus 15.5%).
Critical Care Disparities
Perhaps most concerning was the finding that women were less likely to receive post-stroke cardiac monitoring, with only 19.9% of female patients receiving this crucial follow-up care compared to 23% of male patients. This disparity exists despite the established higher lifetime risk of stroke in women.
Dr. David Z. Rose, professor of vascular neurology at University of South Florida Morsani College of Medicine at Tampa General Hospital and lead investigator of the study, emphasized the significance of these findings. "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," he stated.
Monitoring Effectiveness and Future Directions
The study revealed that atrial fibrillation (AFib) detection rates post-stroke were higher with any type of cardiac monitoring compared to non-cardiac monitoring, regardless of gender. Importantly, there were no sex-based differences observed in the effectiveness of different monitoring types, whether external or insertable cardiac monitors.
This finding is particularly relevant given that AFib can take more than 80 days to manifest post-stroke, underscoring the importance of long-term, insertable cardiac monitoring (ICM) for all eligible patients.
Addressing the Gap
In response to these findings, Medtronic has announced plans for DiVERT Stroke Phase II, which will focus on evaluating opportunities to improve workflow deficiencies, including referral pathways. The goal is to minimize care disparities and ensure more standardized treatment approaches.
Dr. Rose suggested that "standardizing care pathways between neurology and cardiology is one way to help ensure more stroke patients receive guideline-informed cardiac monitoring after a stroke." He also noted the potential role of artificial intelligence solutions in addressing these disparities in future research.
The findings underscore the critical need for healthcare providers to examine and address potential biases in their stroke care protocols, ensuring that all patients receive appropriate cardiac monitoring and specialist referrals based on medical need rather than demographic factors.
