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. 2023 Oct 26;13(1):18375.
doi: 10.1038/s41598-023-45345-3.

Sex-related differences in presentation, treatment, and outcomes of Asian patients with atrial fibrillation: a report from the prospective APHRS-AF Registry

Tommaso Bucci  1   2 , Alena Shantsila  1 , Giulio Francesco Romiti  1   3 , Wee-Siong Teo  4 , Hyung-Wook Park  5 , Wataru Shimizu  6 , Davide Antonio Mei  1   7 , Hung-Fat Tse  8 , Marco Proietti  9   10 , Tze-Fan Chao  11   12 , Gregory Y H Lip  13   14   15 ; Asia-Pacific Heart Rhythm Society Atrial Fibrillation Registry Investigators
Collaborators, Affiliations

Sex-related differences in presentation, treatment, and outcomes of Asian patients with atrial fibrillation: a report from the prospective APHRS-AF Registry

Tommaso Bucci et al. Sci Rep. .

Abstract

We aimed to investigate the sex-related differences in the clinical course of patients with Atrial Fibrillation (AF) enrolled in the Asia-Pacific-Heart-Rhythm-Society Registry. Logistic regression was utilized to investigate the relationship between sex and oral anticoagulant, rhythm control strategies and the 1-year chance to maintain sinus rhythm. Cox-regression was utilized to assess the 1-year risk of all-cause, and cardiovascular death, thromboembolic events, acute coronary syndrome, heart failure, and major bleeding. In the whole cohort (4121 patients, 69 ± 12 years,34.3% female), females had different cardiovascular risk factors, clinical manifestations, and disease perceptions than men, with more advanced age (72 ± 11 vs 67 ± 12 years, p < 0.001) and dyslipidemia (36.7% vs 41.7%, p = 0.002). Coronary artery disease was more prevalent in males (21.1% vs 16.1%, p < 0.001) as well as the use of antiplatelet drugs. Females had a higher use of oral anticoagulant (84.9% vs 81.3%, p = 0.004) but this difference was non-significant after adjustment for confounders. On multivariable analyses, females were less often treated with rhythm control strategies (Odds Ratio [OR] 0.44,95% Confidence Interval [CI] 0.38-0.51) and were less likely to maintain sinus rhythm (OR 0.27, 95% CI 0.22-0.34) compared to males. Cox-regressions analysis showed no sex-related differences for the risk of death, cardiovascular, and bleeding. The clinical management of Asian AF patients should consider several sex-related differences.

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Conflict of interest statement

GFR reports consultancy for Boehringer Ingelheim and an educational grant from Anthos, outside the submitted work. No fees are directly received personally; WS has received grants from Daiichi Sankyo Co., Ltd. and Nippon Boehringer Ingelheim Co., Ltd.; and remuneration for lectures, presentations, speakers’ bureaus, manuscript writing, or educational events from Daiichi Sankyo Co., Ltd., Nippon Boehringer Ingelheim Co., Ltd., Bristol-Meyers Squibb, K.K., Bayer Yakuhin, Ltd., Pfizer Japan, Inc., Ono Pharmaceutical Co., Ltd., and Medtronic Japan Co., Ltd. HFT: is a consultant/speaker fee and research grants from for Abbott; Amgen; AstraZeneca; Bayer; BMS, Boehringer Ingelheim; Boston Scientific; Daiichi Sankyo; Medtronic; Novartis; Pfizer and Sanofi. MP is national leader of the AFFIRMO project on multimorbidity in AF, which has received funding from the European Union’s Horizon 2020 research and innovation program under grant agreement No 899871; GYHL is a consultant and speaker for BMS/Pfizer, Boehringer Ingelheim, Anthos and Daiichi-Sankyo. No fees are received personally. GYHL is co-principal investigator of the AFFIRMO project on multimorbidity in AF, which has received funding from the European Union’s Horizon 2020 research and innovation program under grant agreement No 899871. All other authors report no disclosures.

Figures

Figure 1
Figure 1
Logistic multivariate analysis for factors associated with oral anticoagulant use.
Figure 2
Figure 2
Logistic multivariate analysis for the factors associated with rhythm control strategies after the enrollment.
Figure 3
Figure 3
Logistic multivariate analysis for factors associated with the sinus rhythm maintenance after 1-year of follow-up.
See this image and copyright information in PMC

References

    1. Chugh SS, et al. Worldwide epidemiology of atrial fibrillation: A Global Burden of Disease 2010 Study. Circulation. 2014;129:837–847. doi: 10.1161/CIRCULATIONAHA.113.005119. - DOI - PMC - PubMed
    1. Lip GY, et al. Sex-related differences in presentation, treatment, and outcome of patients with atrial fibrillation in Europe: A report from the Euro Observational Research Programme Pilot survey on Atrial Fibrillation. Europace. 2015;17:24–31. doi: 10.1093/europace/euu155. - DOI - PubMed
    1. Dagres N, et al. Gender-related differences in presentation, treatment, and outcome of patients with atrial fibrillation in Europe: A report from the Euro Heart Survey on Atrial Fibrillation. J. Am. Coll. Cardiol. 2007;49:572–577. doi: 10.1016/j.jacc.2006.10.047. - DOI - PubMed
    1. Avgil Tsadok, M. et al. Sex differences in stroke risk among older patients with recently diagnosed atrial fibrillation. JAMA307, 1952–1958. 10.1001/jama.2012.3490 (2012). - PubMed
    1. Gerdts E, Regitz-Zagrosek V. Sex differences in cardiometabolic disorders. Nat. Med. 2019;25:1657–1666. doi: 10.1038/s41591-019-0643-8. - DOI - PubMed

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