Evers-Dörpfeld, Simone; Aeschbacher, Stefanie; Hennings, Elisa; Eken, Ceylan; Coslovsky, Michael; Rodondi, Nicolas; Beer, Jürg H; Moschovitis, Giorgio; Ammann, Peter; Kobza, Richard; Ceylan, Selinda; Krempke, Melina; Meyer-Zürn, Christine S; Moutzouri, Elisavet; Springer, Anne; Sticherling, Christian; Bonati, Leo H; Osswald, Stefan; Kuehne, Michael and Conen, David (2022). Sex-specific differences in adverse outcome events among patients with atrial fibrillation. Heart (British Cardiac Society), 108(18), pp. 1445-1451. BMJ Publishing Group 10.1136/heartjnl-2021-320122
![[img]](https://boris.unibe.ch/style/images/fileicons/text.png) |
Text
Evers-Dorpfeld_Heart_2022.pdf - Published Version Restricted to registered users only Available under License Publisher holds Copyright. Download (793kB) |
OBJECTIVE
To assess whether women with atrial fibrillation (AF) have a higher risk of adverse events than men during long-term follow-up since controversial data have been published.
METHODS
In the context of two very similar observational multicentre cohort studies, we prospectively followed 3894 patients (28% women) with previously documented AF for a median of 4.02 (3.00-5.83) years. The primary outcome was a composite of ischaemic stroke, myocardial infarction and cardiovascular death. Secondary outcomes included the individual components of the composite outcome, hospitalisation for heart failure, major and clinically relevant non-major bleeding, stroke or systemic embolism and non-cardiovascular death.
RESULTS
Mean age was 73.1 years in women vs 70.8 years in men. The incidence of the primary endpoint in women versus men was 2.46 vs 3.24 per 100 patient-years, respectively (adjusted HR (aHR) 0.74, 95% CI 0.58 to 0.94; p=0.01). Women died less frequently from cardiovascular (aHR 0.57, 95% CI 0.41 to 0.78; p<0.001) and non-cardiovascular causes (aHR 0.68, 95% CI 0.47 to 0.98; p=0.04). There were no significant sex-specific differences in stroke (incidence 1.05 vs 1.00; aHR 1.02, 95% CI 0.70 to 1.49, p=0.93), myocardial infarction (incidence 0.67 vs 0.72; aHR 0.98, 95% CI 0.61 to 1.57, p=0.94), major and clinically relevant non-major bleeding (incidence 4.51 vs 4.34; aHR 0.95, 95% CI 0.79 to 1.15, p=0.63) or heart failure hospitalisation (incidence 3.28 vs 3.07; aHR 1.06, 95% CI 0.85 to 1.32, p=0.60).
CONCLUSION
In this large study of patients with established AF, women had a lower risk of death than men, but there were no sex-specific differences in other adverse outcomes.
Actions (login required)
 |
Edit item |