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Anti-clotting treatment underused at many hospitals

WASHINGTON D.C., May 17 Academic hospitals are more likely than community or Veteran's Administration (VA) hospitals to follow national guidelines for treating patients at risk for blood clots with aspirin or warfarin.

That's one of the findings of a study presented today at the American Heart Association's 5th annual Scientific Forum on Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke.

Among patients diagnosed with heart attack, 84.3 percent of those studied received aspirin upon arrival at academic hospitals, while just 65.8 percent at community hospitals and 60.2 percent at VA hospitals received it.

"This is really important because early administration of aspirin improves both the survival and reperfusion rates of the patients," said Joseph A. Caprini, M.D., director of surgical research at Evanston Northwestern Healthcare and Feinberg School of Medicine.

The only exception was that VA hospitals performed better in using drugs to prevent blood clots in patients with atrial fibrillation, an irregular heartbeat that increases the risk for stroke.

"Although the guidelines recommend the use of anticoagulants, in actual practice, for one reason or another, the patients aren't getting the drug," Caprini said.

"Some of the hospitals in this study were among the best in the country. We need to bridge the gap between evidence-based guidelines and treatment based on good results in clinical practice. These differences are not because doctors don't know enough, it's because clinical practice is complicated."

The study compared treatment among 38 hospitals: 21 academic (2,077 patients), 13 community (1,295 patients) and four VA hospitals (406 patients). The researchers reviewed records for patients diagnosed with atrial fibrillation, heart attack, deep vein thrombosis (blood clot in the leg), hip fracture or patients undergoing total hip or knee replacement surgery. These conditions increase the risk of b
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Contact: Carole Bullock
carole.bullock@heart.org
214-706-1279
American Heart Association
17-May-2004


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