Sex differences of vascular brain lesions in patients with atrial fibrillation.

Ceylan, Selinda; Aeschbacher, Stefanie; Altermatt, Anna; Sinnecker, Tim; Rodondi, Nicolas; Blum, Manuel; Coslovsky, Michael; Evers-Dörpfeld, Simone; Niederberger, Sacha; Conen, David; Osswald, Stefan; Kühne, Michael; Düring, Marco; Wuerfel, Jens; Bonati, Leo (2022). Sex differences of vascular brain lesions in patients with atrial fibrillation. Open Heart, 9(2), e002033. B M J Group 10.1136/openhrt-2022-002033

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OBJECTIVE

To examine sex differences in prevalence, volume and distribution of vascular brain lesions on MRI among patients with atrial fibrillation (AF).

METHODS

In this cross-sectional analysis, we included 1743 patients with AF (27% women) from the multicentre Swiss Atrial Fibrillation study (SWISS-AF) with available baseline brain MRI. We compared presence and total volume of large non-cortical or cortical infarcts (LNCCIs), small non-cortical infarcts, microbleeds (MB) and white matter hyperintensities (WMH, Fazekas score ≥2 for moderate or severe degree) between men and women with multivariable logistic regression. We generated voxel-based probability maps to assess the anatomical distribution of lesions.

RESULTS

We found no strong evidence for an association of female sex with the prevalence of all ischaemic infarcts (LNCCI and SNCI combined; adjusted OR 0.86, 95% CI 0.67 to 1.09, p=0.22), MB (adjusted OR 0.91, 95% CI 0.68 to 1.21, p=0.52) and moderate or severe WMH (adjusted OR 1.15, 95% CI 0.90 to 1.48, p=0.27). However, total WMH volume was 17% larger among women than men (multivariable adjusted multiplicative effect 1.17, 95% CI 1.01 to 1.35; p=0.04). Lesion probability maps showed a right hemispheric preponderance of ischaemic infarcts in both men and women, while WMH were distributed symmetrically.

CONCLUSION

Women had higher white matter disease burden than men, while volume and prevalence of other lesions did not differ. Our findings highlight the importance of controlling risk factors for cerebral small vessel disease in patients with AF, especially among women.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine
04 Faculty of Medicine > Medical Education > Institute of General Practice and Primary Care (BIHAM)
04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine > Centre of Competence for General Internal Medicine

UniBE Contributor:

Rodondi, Nicolas and Blum, Manuel

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

2053-3624

Publisher:

B M J Group

Funders:

[4] Swiss National Science Foundation ; [116] Swiss Heart Foundation = Schweizerische Herzstiftung

Language:

English

Submitter:

Pubmed Import

Date Deposited:

14 Sep 2022 14:39

Last Modified:

21 Sep 2022 16:43

Publisher DOI:

10.1136/openhrt-2022-002033

PubMed ID:

36100317

Uncontrolled Keywords:

Atrial Fibrillation Atrial Flutter STROKE

BORIS DOI:

10.48350/172860

URI:

https://boris.unibe.ch/id/eprint/172860

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