Receipt of cardiac screening does not influence 1-year post-cerebrovascular event mortality
dc.contributor.author | Sico, Jason J. | |
dc.contributor.author | Baye, Fitsum | |
dc.contributor.author | Myers, Laura J. | |
dc.contributor.author | Concato, John | |
dc.contributor.author | Ferguson, Jared | |
dc.contributor.author | Cheng, Eric M. | |
dc.contributor.author | Jadbabaie, Farid | |
dc.contributor.author | Yu, Zhangsheng | |
dc.contributor.author | Arling, Gregory | |
dc.contributor.author | Zillich, Alan J. | |
dc.contributor.author | Reeves, Matthew J. | |
dc.contributor.author | Williams, Linda S. | |
dc.contributor.author | Bravata, Dawn M. | |
dc.contributor.department | Biostatistics, School of Public Health | en_US |
dc.date.accessioned | 2019-05-09T20:29:29Z | |
dc.date.available | 2019-05-09T20:29:29Z | |
dc.date.issued | 2018-06 | |
dc.description.abstract | Background: American Heart Association/American Stroke Association expert consensus guidelines recommend consideration of cardiac stress testing to screen for occult coronary heart disease (CHD) among patients with ischemic stroke/TIA who have a high-risk Framingham Cardiac Risk Score (FCRS). Whether this guideline is being implemented in routine clinical practice, and the association of its implementation with mortality, is less clear. Methods: Study participants were Veterans with stroke/TIA (n = 11,306) during fiscal year 2011 who presented to a VA Emergency Department or who were admitted. Patients were excluded (n = 6,915) based on prior CHD/angina/chest pain history, receipt of cardiac stress testing within 18 months prior to cerebrovascular event, death within 90 days of discharge, discharge to hospice, transfer to a non-VA acute care facility, or missing/unknown race. FCRS ≥20% was classified as high risk for CHD. ICD-9 and Common Procedural Terminology codes were used to identify receipt of any cardiac stress testing. Results: Among 4,391 eligible patients, 62.8% (n = 2,759) had FCRS ≥20%. Cardiac stress testing was performed infrequently and in similar proportion among high-risk (4.5% [123/2,759]) vs low/intermediate-risk (4.4% [72/1,632]) patients (adjusted odds ratio [aOR] 0.77, 95% confidence interval [CI] 0.54-1.10). Receipt of stress testing was not associated with reduced 1-year mortality (aOR 0.59, CI 0.26-1.30). Conclusions: In this observational cohort study of patients with cerebrovascular disease, cardiac screening was relatively uncommon and was not associated with 1-year mortality. Additional work is needed to understand the utility of CHD screening among high-risk patients with cerebrovascular disease. | en_US |
dc.identifier.citation | Sico, J. J., Baye, F., Myers, L. J., Concato, J., Ferguson, J., Cheng, E. M., … Bravata, D. M. (2018). Receipt of cardiac screening does not influence 1-year post-cerebrovascular event mortality. Neurology. Clinical practice, 8(3), 192–200. doi:10.1212/CPJ.0000000000000465 | en_US |
dc.identifier.uri | https://hdl.handle.net/1805/19206 | |
dc.language.iso | en_US | en_US |
dc.publisher | Wolters Kluwer | en_US |
dc.relation.isversionof | 10.1212/CPJ.0000000000000465 | en_US |
dc.relation.journal | Neurology: Clinical practice | en_US |
dc.rights | Attribution-NonCommercial-NoDerivs 3.0 United States | * |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/3.0/us/ | * |
dc.source | PMC | en_US |
dc.subject | Cardiac stress testing | en_US |
dc.subject | Occult coronary heart disease | en_US |
dc.subject | Framingham Cardiac Risk Score | en_US |
dc.subject | Ischemic stroke/TIA | en_US |
dc.title | Receipt of cardiac screening does not influence 1-year post-cerebrovascular event mortality | en_US |
dc.type | Article | en_US |