A study led by researchers at Duke Medicine shows that among thousands of hospital patients treated for a transient ischemic attack (TIA), those at highest risk for suffering a full-blown ischemic attack were less likely to receive optimal care. The research team used a large database of stroke patients from more than 1,600 hospitals in the US to study the profiles and treatment approaches for nearly 59,000 people on Medicare who suffered a TIA between 2003 and 2008. Patients were then divided into five risk categories based on health information and other demographic factors.

The healthiest patients more often received optimal care, which included treatments like anticlotting drugs in the hospital and discharge. Emily C. O’Brien, PhD, lead author of the study, explains, “Studies have shown that there are effective strategies for treating TIAs, and patients who receive the optimal care have fewer readmissions for a subsequent ischemic stroke. But that optimal care was often not provided for the patients who needed it most.”

The sickest patients, who included people who had diabetes, heart failure, heart attacks, and other health concerns, two specific treatment strategies were frequently lacking: anticoagulant drugs for atrial fibrillation and statins for high cholesterol. According to a Duke Medicine news release, the database showed that these patients were more likely to be readmitted to the hospital for ischemic stroke within 1 year of having a TIA.

O’Brien says, “We found that there’s a real need for more work in high-risk populations to deliver optimal care and eliminate this mismatch in treatment.”

Source: Duke Medicine