Early Care by Cardiologist May Lower Stroke Risk for A-Fib Patients
MONDAY, June 26, 2017 -- Patients with a common heart rhythm disorder who receive a cardiologist's care soon after diagnosis are less likely to suffer a stroke, a new study finds.
Atrial fibrillation, or A-fib, is an irregular, often rapid heart rate that increases the risk of stroke and other complications. It affects between 3 million and 5 million Americans.
Researchers from Stanford University School of Medicine analyzed data on more than 184,000 people diagnosed with atrial fibrillation between 2004 and 2012. Within 90 days of diagnosis, 40 percent were cared for by a cardiologist and 60 percent by a primary care doctor only.
Patients seen by cardiologists had a 9 percent lower risk of stroke and an 11 percent lower risk of early death, the study found. The lower stroke risk probably resulted from a higher rate of prescriptions for blood-thinning drugs that prevent blood clots, according to the researchers.
"The important message here is that getting early cardiology care was associated with early prescription of drugs specifically for preventing stroke. These findings show that it is important to think of these interventions at the time of diagnosis," study senior author Dr. Mintu Turakhia said in a university news release.
Turakhia is research director at the Stanford's Center for Digital Health and head of cardiac electrophysiology at the Palo Alto Veterans Affairs Health Care System.
"When you account for everything under the sun -- age, other conditions and medications, insurance coverage and even how far patients lived from these clinics -- there was still a reduction in stroke and mortality," Turakhia said.
The study also found that patients who got early cardiology care were more likely to be hospitalized. Turakhia said that might be because they tended to be sicker or that perhaps in-patient therapies were deemed beneficial. Patients who received specialized care lived closer to the cardiologists than those who got primary care.
The study, which only observed an association between cardiologist care and patient outcome, does not prove that cardiologists rather than primary care doctors should be treating all patients with atrial fibrillation.
"We're not saying that we just need to clone more cardiologists -- that is exactly the wrong solution," Turakhia said. "Rather this research indicates that we need to fill gaps in care and find smarter ways to deliver it so it doesn't matter who a patient sees or how far away they live."
The study was published online June 26 in the Journal of the American College of Cardiology.
The U.S. National Heart, Lung, and Blood Institute has more on atrial fibrillation.
Posted: June 2017