New findings from the DiVERT Stroke clinical study show that women spent less time in the hospital, saw fewer referrals to cardiology and were prescribed less frequent post-stroke cardiac monitoring than men when admitted to comprehensive stroke centres (CSCs) following their stroke. The data were presented at the 2025 International Stroke Conference (ISC; 5–7 February, Los Angeles, USA).
A Medtronic press release highlighting these findings states that post-stroke cardiac monitoring is key to informing strategies to help prevent future strokes, while multiple clinical studies have shown that patients with cryptogenic stroke—strokes of unknown cause—are at high risk of atrial fibrillation (AF) post-stroke and, for many stroke patients, it could take more than 80 days for AF to appear, reinforcing the importance of long-term, insertable cardiac monitoring. While previous studies have shown discrepancies in stroke care for women compared to men, the full extent of sex disparities for cardiology consultation and post-stroke cardiac monitoring remains understudied, the release adds.
The retrospective analysis from the DiVERT Stroke study found that, among 2,699 patients, female patients—who accounted for 48% of study participants—were less likely than male patients to receive cardiology referrals during index hospitalisation (12.8% vs 15.5%; p=0.043), had shorter length of stay (6.8 vs 7.7 days; p=0.025), and were less likely to receive post-stroke cardiac monitoring (19.9% vs 23%; p=0.048). Additionally, the rate of AF detected post-stroke was higher for any type of cardiac monitoring versus ‘non-monitoring’, irrespective of sex—7.4% vs 3.9% (p=0.015) for women and 8% vs 3.5% (p<0.001) for men—and there were no sex differences between types of cardiac monitoring (external monitors versus insertable cardiac monitors [ICMs]).
“Women have a higher lifetime risk of stroke compared to men and yet these findings suggest that, when it comes to post-stroke care, women are seeing cardiology less often and getting less cardiac monitoring care than their male counterparts,” said David Rose (Tampa General Hospital, Tampa, USA), lead investigator in the DiVERT Stroke study who presented the data at ISC 2025. “Standardising care pathways between neurology and cardiology is one way to help ensure more stroke patients receive guideline-informed cardiac monitoring after a stroke. Further research on this topic is needed and may include artificial intelligence [AI] solutions.”
The DiVERT Stroke study examined in-hospital care pathways for patients with cryptogenic, large-vessel atherosclerotic disease and small vessel disease stroke subtypes. Post-stroke care pathways were assessed using in-person clinician interviews across cardiology and vascular neurology subspecialities, while patient data were collected using electronic medical records and the American Heart Association (AHA) Get with the Guidelines (GWTG) registry from 2017 to 2019. Baseline demographics and six-month post-index stroke discharge data were collected at five CSCs in the USA.
The statistical differences seen here could represent sex disparities that impact preventive actions for secondary stroke and long-term outcomes, Medtronic’s release notes, also reporting that Phase II of the DiVERT Stroke study will evaluate opportunities to improve workflow deficiencies—including referral pathways—to help minimise disparities of care.
