That's because patients with a high stroke risk due to heart rhythm problems are likely to turn up at the ER for symptoms of their irregular heartbeat, giving doctors a chance to make sure they're on the best drugs to prevent a stroke.

The study's results show that ER patients on the whole are 20 percent more likely than the general population to have the heart rhythm irregularity called atrial fibrillation, which significantly raises the risk of stroke.

But only 55 percent of the AF patients seen in the ER who could be taking the best available medication to prevent strokes actually are taking that drug. The study's authors say the ER could be a good place to identify AF patients who aren't getting the best preventive therapy they can get, and to help steer them to better treatment.

The study, published in the November issue of Stroke, was conducted at three hospitals, and led by a researcher from the University of Michigan Health System.

"The scope of the problem is extraordinarily large," says lead author Phillip A. Scott, M.D., an assistant professor of emergency medicine at UMHS and member of the UMHS Stroke Program. "The ER is potentially an efficient place to identify untreated and under-treated atrial fibrillation patients, to inform them of their stroke risk, and to treat them or refer them for treatment."

AF can cause blood to pool and clot in the heart's upper chambers, leading to a stroke when clots leave the heart and travel to the brain. About 15 percent of the nation's strokes occur among the 2 million Americans with AF, who often have other cardiovascular diseases like clogged arteries, high blood pressure, or heart failure.

The idea of using ER visits for preventive care is a relatively new one, Scott says, but research at UMHS and elsewhere has shown that such vi
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Contact: Kara Gavin
kegavin@umich.edu
734-764-2220
University of Michigan Health System
31-Oct-2002