Echocardiography in stroke and the prescription of new anticoagulation and cardiac medications: a pilot project.
Previous research on echocardiography in patients with acute stroke has focused on identifying possible cardioembolic etiologies of the stroke, but physicians might also obtain echocardiography to guide the management of heart disease in stroke patients. The objectives of this study were to determine how frequently echocardiography is used in acute ischemic stroke patients, and to evaluate if receiving echocardiography is associated with new prescriptions for anticoagulant or cardiac medications. This secondary data analysis of a previous cohort study included medical records of acute ischemic stroke patients admitted to 1 of 10 acute-care hospitals in Connecticut from 1996 to 1998. A total of 58 of 119 (49%) acute ischemic stroke patients received echocardiography. Among these 58 patients, 43 (74%) received either a new prescription for anticoagulation or a new cardiac medication prescription (10 of 58 [17%] new anticoagulation only, 22 of 58 [38%] new cardiac medication only, and 11 of 58 [19%] both). New anticoagulant medications were prescribed more often in patients receiving echocardiography (21 of 58; 36%), than in patients not receiving echocardiography (10 of 61; 16%) (P = .014). In addition, new cardiac medications were prescribed more often in patients receiving echocardiography (34 of 58; 59%), than in patients not receiving echocardiography (24 of 61; 39%) (P = .035). Echocardiography is commonly obtained in patients with acute stroke, and its use is associated with both the prescription of new anticoagulation and new cardiac medications. Although previous research about the use of echocardiography in acute stroke has focused on its role in identifying stroke etiologies, future research should include an assessment of it use in treating concomitant heart disease.
Bravata
Dawn M
DM
Clinical Epidemiology Research Center, VA Connecticut Healthcare System, West Haven, Connecticut USA.
Concato
John
J
Kim
Nancy
N
Brass
Lawrence M
LM