Gender differences in clinical presentation and 1-year outcomes in atrial fibrillation

ObjectivesOur objective was to examine gender differences in clinical presentation, management and prognosis of atrial fibrillation (AF) in a contemporary cohort.MethodsIn 6412 patients, 39.7% women, of the PREvention oF thromboembolic events – European Registry in Atrial Fibrillation, we examined g...

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Published in:Heart (British Cardiac Society) Vol. 103; no. 13; pp. 1024 - 1030
Main Authors: Schnabel, Renate B, Pecen, Ladislav, Ojeda, Francisco M, Lucerna, Markus, Rzayeva, Nargiz, Blankenberg, Stefan, Darius, Harald, Kotecha, Dipak, Caterina, Raffaele De, Kirchhof, Paulus
Format: Journal Article
Language:English
Published: England BMJ Publishing Group LTD 01.07.2017
BMJ Publishing Group
Series:Original research article
Subjects:
Age Factors
Aged
Anticoagulants - therapeutic use
Atrial Fibrillation - complications
Atrial Fibrillation - drug therapy
Atrial Fibrillation - epidemiology
Cardiac arrhythmia
Cardiac Risk Factors and Prevention
Catheters
Europe - epidemiology
Female
Follow-Up Studies
Gender differences
Humans
Incidence
Male
Prognosis
Registries
Retrospective Studies
Risk Factors
Sex Distribution
Sex Factors
Stroke
Survival Rate - trends
Thromboembolism - epidemiology
Thromboembolism - etiology
Thromboembolism - prevention & control
Time Factors
Womens health
European registry
Atrial fibrillation
gender differences
ISSN:1355-6037, 1468-201X, 1468-201X
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Abstract ObjectivesOur objective was to examine gender differences in clinical presentation, management and prognosis of atrial fibrillation (AF) in a contemporary cohort.MethodsIn 6412 patients, 39.7% women, of the PREvention oF thromboembolic events – European Registry in Atrial Fibrillation, we examined gender differences in symptoms, risk factors, therapies and 1-year incidence of adverse outcomes.ResultsMen with AF were on average younger than women (mean±SD: 70.1±10.7 vs 74.1±9.7 years, p<0.0001). Women more frequently had at least one AF-related symptom at least occasionally compared with men (95.4% in women, 89.8% in men, p<0.0001). Prescription of oral anticoagulation was similar, with an increase of non-vitamin K antagonist oral anticoagulants from 5.9% to 12.6% in women and from 6.2% to 12.6% in men, p<0.0001 for both.Men were more frequently treated with electrical cardioversion and ablation (20.6% and 6.3%, respectively) than women (14.9% and 3.3%, respectively), p<0.0001. Women had 65% (OR: 0.35; 95% CI (0.22 to 0.56)) lower age-adjusted and country-adjusted odds of coronary revascularisation, 40% (OR: 0.60; (0.38 to 0.93)) lower odds of acute coronary syndrome and 20% (OR: 0.80; (0.68 to 0.96)) lower odds of heart failure at 1 year. There were no statistically significant gender differences in 1-year stroke/transient ischaemic attack/arterial thromboembolism and major bleeding events.ConclusionIn a ‘real-world’ European AF registry, women were more symptomatic but less likely to receive invasive rhythm control therapy such as electrical cardioversion or ablation. Further study is needed to confirm that these differences do not disadvantage women with AF.
AbstractList Our objective was to examine gender differences in clinical presentation, management and prognosis of atrial fibrillation (AF) in a contemporary cohort. In 6412 patients, 39.7% women, of the PREvention oF thromboembolic events - European Registry in Atrial Fibrillation, we examined gender differences in symptoms, risk factors, therapies and 1-year incidence of adverse outcomes. Men with AF were on average younger than women (mean±SD: 70.1±10.7 vs 74.1±9.7 years, p<0.0001). Women more frequently had at least one AF-related symptom at least occasionally compared with men (95.4% in women, 89.8% in men, p<0.0001). Prescription of oral anticoagulation was similar, with an increase of non-vitamin K antagonist oral anticoagulants from 5.9% to 12.6% in women and from 6.2% to 12.6% in men, p<0.0001 for both.Men were more frequently treated with electrical cardioversion and ablation (20.6% and 6.3%, respectively) than women (14.9% and 3.3%, respectively), p<0.0001. Women had 65% (OR: 0.35; 95% CI (0.22 to 0.56)) lower age-adjusted and country-adjusted odds of coronary revascularisation, 40% (OR: 0.60; (0.38 to 0.93)) lower odds of acute coronary syndrome and 20% (OR: 0.80; (0.68 to 0.96)) lower odds of heart failure at 1 year. There were no statistically significant gender differences in 1-year stroke/transient ischaemic attack/arterial thromboembolism and major bleeding events. In a 'real-world' European AF registry, women were more symptomatic but less likely to receive invasive rhythm control therapy such as electrical cardioversion or ablation. Further study is needed to confirm that these differences do not disadvantage women with AF.
Our objective was to examine gender differences in clinical presentation, management and prognosis of atrial fibrillation (AF) in a contemporary cohort.OBJECTIVESOur objective was to examine gender differences in clinical presentation, management and prognosis of atrial fibrillation (AF) in a contemporary cohort.In 6412 patients, 39.7% women, of the PREvention oF thromboembolic events - European Registry in Atrial Fibrillation, we examined gender differences in symptoms, risk factors, therapies and 1-year incidence of adverse outcomes.METHODSIn 6412 patients, 39.7% women, of the PREvention oF thromboembolic events - European Registry in Atrial Fibrillation, we examined gender differences in symptoms, risk factors, therapies and 1-year incidence of adverse outcomes.Men with AF were on average younger than women (mean±SD: 70.1±10.7 vs 74.1±9.7 years, p<0.0001). Women more frequently had at least one AF-related symptom at least occasionally compared with men (95.4% in women, 89.8% in men, p<0.0001). Prescription of oral anticoagulation was similar, with an increase of non-vitamin K antagonist oral anticoagulants from 5.9% to 12.6% in women and from 6.2% to 12.6% in men, p<0.0001 for both.Men were more frequently treated with electrical cardioversion and ablation (20.6% and 6.3%, respectively) than women (14.9% and 3.3%, respectively), p<0.0001. Women had 65% (OR: 0.35; 95% CI (0.22 to 0.56)) lower age-adjusted and country-adjusted odds of coronary revascularisation, 40% (OR: 0.60; (0.38 to 0.93)) lower odds of acute coronary syndrome and 20% (OR: 0.80; (0.68 to 0.96)) lower odds of heart failure at 1 year. There were no statistically significant gender differences in 1-year stroke/transient ischaemic attack/arterial thromboembolism and major bleeding events.RESULTSMen with AF were on average younger than women (mean±SD: 70.1±10.7 vs 74.1±9.7 years, p<0.0001). Women more frequently had at least one AF-related symptom at least occasionally compared with men (95.4% in women, 89.8% in men, p<0.0001). Prescription of oral anticoagulation was similar, with an increase of non-vitamin K antagonist oral anticoagulants from 5.9% to 12.6% in women and from 6.2% to 12.6% in men, p<0.0001 for both.Men were more frequently treated with electrical cardioversion and ablation (20.6% and 6.3%, respectively) than women (14.9% and 3.3%, respectively), p<0.0001. Women had 65% (OR: 0.35; 95% CI (0.22 to 0.56)) lower age-adjusted and country-adjusted odds of coronary revascularisation, 40% (OR: 0.60; (0.38 to 0.93)) lower odds of acute coronary syndrome and 20% (OR: 0.80; (0.68 to 0.96)) lower odds of heart failure at 1 year. There were no statistically significant gender differences in 1-year stroke/transient ischaemic attack/arterial thromboembolism and major bleeding events.In a 'real-world' European AF registry, women were more symptomatic but less likely to receive invasive rhythm control therapy such as electrical cardioversion or ablation. Further study is needed to confirm that these differences do not disadvantage women with AF.CONCLUSIONIn a 'real-world' European AF registry, women were more symptomatic but less likely to receive invasive rhythm control therapy such as electrical cardioversion or ablation. Further study is needed to confirm that these differences do not disadvantage women with AF.
ObjectivesOur objective was to examine gender differences in clinical presentation, management and prognosis of atrial fibrillation (AF) in a contemporary cohort.MethodsIn 6412 patients, 39.7% women, of the PREvention oF thromboembolic events – European Registry in Atrial Fibrillation, we examined gender differences in symptoms, risk factors, therapies and 1-year incidence of adverse outcomes.ResultsMen with AF were on average younger than women (mean±SD: 70.1±10.7 vs 74.1±9.7 years, p<0.0001). Women more frequently had at least one AF-related symptom at least occasionally compared with men (95.4% in women, 89.8% in men, p<0.0001). Prescription of oral anticoagulation was similar, with an increase of non-vitamin K antagonist oral anticoagulants from 5.9% to 12.6% in women and from 6.2% to 12.6% in men, p<0.0001 for both.Men were more frequently treated with electrical cardioversion and ablation (20.6% and 6.3%, respectively) than women (14.9% and 3.3%, respectively), p<0.0001. Women had 65% (OR: 0.35; 95% CI (0.22 to 0.56)) lower age-adjusted and country-adjusted odds of coronary revascularisation, 40% (OR: 0.60; (0.38 to 0.93)) lower odds of acute coronary syndrome and 20% (OR: 0.80; (0.68 to 0.96)) lower odds of heart failure at 1 year. There were no statistically significant gender differences in 1-year stroke/transient ischaemic attack/arterial thromboembolism and major bleeding events.ConclusionIn a ‘real-world’ European AF registry, women were more symptomatic but less likely to receive invasive rhythm control therapy such as electrical cardioversion or ablation. Further study is needed to confirm that these differences do not disadvantage women with AF.
Objectives Our objective was to examine gender differences in clinical presentation, management and prognosis of atrial fibrillation (AF) in a contemporary cohort. Methods In 6412 patients, 39.7% women, of the PREvention oF thromboembolic events - European Registry in Atrial Fibrillation, we examined gender differences in symptoms, risk factors, therapies and 1-year incidence of adverse outcomes. Results Men with AF were on average younger than women (mean±SD: 70.1±10.7 vs 74.1±9.7 years, p<0.0001). Women more frequently had at least one AF-related symptom at least occasionally compared with men (95.4% in women, 89.8% in men, p<0.0001). Prescription of oral anticoagulation was similar, with an increase of non-vitamin K antagonist oral anticoagulants from 5.9% to 12.6% in women and from 6.2% to 12.6% in men, p<0.0001 for both. Men were more frequently treated with electrical cardioversion and ablation (20.6% and 6.3%, respectively) than women (14.9% and 3.3%, respectively), p<0.0001. Women had 65% (OR: 0.35; 95% CI (0.22 to 0.56)) lower age-adjusted and country-adjusted odds of coronary revascularisation, 40% (OR: 0.60; (0.38 to 0.93)) lower odds of acute coronary syndrome and 20% (OR: 0.80; (0.68 to 0.96)) lower odds of heart failure at 1 year. There were no statistically significant gender differences in 1-year stroke/transient ischaemic attack/arterial thromboembolism and major bleeding events. Conclusion In a 'real-world' European AF registry, women were more symptomatic but less likely to receive invasive rhythm control therapy such as electrical cardioversion or ablation. Further study is needed to confirm that these differences do not disadvantage women with AF.
Author Caterina, Raffaele De
Schnabel, Renate B
Blankenberg, Stefan
Kirchhof, Paulus
Ojeda, Francisco M
Rzayeva, Nargiz
Lucerna, Markus
Darius, Harald
Kotecha, Dipak
Pecen, Ladislav
AuthorAffiliation 7 Fondazione G. Monasterio , Pisa , Italy
9 AFNET , Münster , Germany
1 Department of Cardiology , University Heart Center Hamburg–Eppendorf, German Center for Cardiovascular Research (DZHK) partner site Hamburg/Kiel/Lübeck , Hamburg , Germany
4 Department of Cardiology, Angiology, Nephrology and Conservative Intensive Care Medicine , Vivantes Klinikum Neukolln , Berlin , Germany
6 G. d’Annunzio University of Chieti–Pescara , Chieti , Italy
8 Institute of Cardiovascular Sciences , University of Birmingham and SWBH and UHB NHS Trust , Birmingham , UK
3 Daiichi Sankyo Europe GmbH , Munich , Germany
2 Medical Facility Pilsen of Charles University , Pilsen , Czech Republic
5 School of Clinical & Experimental Medicine , University of Birmingham , Birmingham , UK
AuthorAffiliation_xml – name: 2 Medical Facility Pilsen of Charles University , Pilsen , Czech Republic
– name: 6 G. d’Annunzio University of Chieti–Pescara , Chieti , Italy
– name: 3 Daiichi Sankyo Europe GmbH , Munich , Germany
– name: 1 Department of Cardiology , University Heart Center Hamburg–Eppendorf, German Center for Cardiovascular Research (DZHK) partner site Hamburg/Kiel/Lübeck , Hamburg , Germany
– name: 8 Institute of Cardiovascular Sciences , University of Birmingham and SWBH and UHB NHS Trust , Birmingham , UK
– name: 5 School of Clinical & Experimental Medicine , University of Birmingham , Birmingham , UK
– name: 4 Department of Cardiology, Angiology, Nephrology and Conservative Intensive Care Medicine , Vivantes Klinikum Neukolln , Berlin , Germany
– name: 7 Fondazione G. Monasterio , Pisa , Italy
– name: 9 AFNET , Münster , Germany
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  givenname: Renate B
  surname: Schnabel
  fullname: Schnabel, Renate B
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  organization: Department of Cardiology, University Heart Center Hamburg–Eppendorf, German Center for Cardiovascular Research (DZHK) partner site Hamburg/Kiel/Lübeck, Hamburg, Germany
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  givenname: Ladislav
  surname: Pecen
  fullname: Pecen, Ladislav
  email: r.schnabel@uke.de
  organization: Medical Facility Pilsen of Charles University, Pilsen, Czech Republic
– sequence: 3
  givenname: Francisco M
  surname: Ojeda
  fullname: Ojeda, Francisco M
  email: r.schnabel@uke.de
  organization: Department of Cardiology, University Heart Center Hamburg–Eppendorf, German Center for Cardiovascular Research (DZHK) partner site Hamburg/Kiel/Lübeck, Hamburg, Germany
– sequence: 4
  givenname: Markus
  surname: Lucerna
  fullname: Lucerna, Markus
  email: r.schnabel@uke.de
  organization: Daiichi Sankyo Europe GmbH, Munich, Germany
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  givenname: Nargiz
  surname: Rzayeva
  fullname: Rzayeva, Nargiz
  email: r.schnabel@uke.de
  organization: Department of Cardiology, University Heart Center Hamburg–Eppendorf, German Center for Cardiovascular Research (DZHK) partner site Hamburg/Kiel/Lübeck, Hamburg, Germany
– sequence: 6
  givenname: Stefan
  surname: Blankenberg
  fullname: Blankenberg, Stefan
  email: r.schnabel@uke.de
  organization: Department of Cardiology, University Heart Center Hamburg–Eppendorf, German Center for Cardiovascular Research (DZHK) partner site Hamburg/Kiel/Lübeck, Hamburg, Germany
– sequence: 7
  givenname: Harald
  surname: Darius
  fullname: Darius, Harald
  email: r.schnabel@uke.de
  organization: Department of Cardiology, Angiology, Nephrology and Conservative Intensive Care Medicine, Vivantes Klinikum Neukolln, Berlin, Germany
– sequence: 8
  givenname: Dipak
  surname: Kotecha
  fullname: Kotecha, Dipak
  email: r.schnabel@uke.de
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– sequence: 9
  givenname: Raffaele De
  surname: Caterina
  fullname: Caterina, Raffaele De
  email: r.schnabel@uke.de
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– sequence: 10
  givenname: Paulus
  surname: Kirchhof
  fullname: Kirchhof, Paulus
  email: r.schnabel@uke.de
  organization: AFNET, Münster, Germany
BackLink https://www.ncbi.nlm.nih.gov/pubmed/28228467$$D View this record in MEDLINE/PubMed
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ContentType Journal Article
Copyright Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Copyright: 2017 © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted. 2017
Copyright_xml – notice: Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
– notice: Copyright: 2017 © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
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DOI 10.1136/heartjnl-2016-310406
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Issue 13
Keywords European registry
Atrial fibrillation
gender differences
Language English
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Snippet ObjectivesOur objective was to examine gender differences in clinical presentation, management and prognosis of atrial fibrillation (AF) in a contemporary...
Our objective was to examine gender differences in clinical presentation, management and prognosis of atrial fibrillation (AF) in a contemporary cohort. In...
Objectives Our objective was to examine gender differences in clinical presentation, management and prognosis of atrial fibrillation (AF) in a contemporary...
Our objective was to examine gender differences in clinical presentation, management and prognosis of atrial fibrillation (AF) in a contemporary...
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SubjectTerms Age Factors
Aged
Anticoagulants - therapeutic use
Atrial Fibrillation - complications
Atrial Fibrillation - drug therapy
Atrial Fibrillation - epidemiology
Cardiac arrhythmia
Cardiac Risk Factors and Prevention
Catheters
Europe - epidemiology
Female
Follow-Up Studies
Gender differences
Humans
Incidence
Male
Prognosis
Registries
Retrospective Studies
Risk Factors
Sex Distribution
Sex Factors
Stroke
Survival Rate - trends
Thromboembolism - epidemiology
Thromboembolism - etiology
Thromboembolism - prevention & control
Time Factors
Womens health
Title Gender differences in clinical presentation and 1-year outcomes in atrial fibrillation
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