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

Author:

Bucci Tommaso,Shantsila Alena,Romiti Giulio Francesco,Teo Wee-Siong,Park Hyung-Wook,Shimizu Wataru,Mei Davide Antonio,Tse Hung-Fat,Proietti Marco,Chao Tze-Fan,Lip Gregory Y. H.,David Chun-Wah Siu,Shimizu Wataru,Yodogawa Kenji,Tsutsui Hiroyuki,Mukai Yasushi,Tomita Hirofumi,Horiuchi Daisuke,Hagii Joji,Aonuma Kazutaka,Okumura Yasuo,Goya Masahiko,Hirao Kenzo,Ajioka Masayoshi,Hagiwara Nobuhisa,Suzuki Atsushi,Yamane Teiichi,Ikeda Takanori,Yuzawa Hitomi,Satomi Kazuhiro,Yazaki Yoshinao,Fukuda Keiichi,Kobayashi Yoshinori,Morita Norishige,Murohara Toyoaki,Watanabe Eiichi,Harada Masahide,Sakagami Satoru,Saeki Takahiro,Kusano Kengo,Miyamoto Koji,Miyazaki Shinsuke,Tada Hiroshi,Inoue Koichi,Tanaka Nobuaki,Koretsune Yukihiro,Abe Haruhiko,Kihara Yasuki,Nakano Yukiko,Shimizu Akihiko,Yoshiga Yasuhiro,Sakamoto Tomohiro,Okumur Ken,Takahashi Naohiko,Shinohara Tetsuji,Soejima Kyoko,Takagi Masahiko,Kawamura Mitsuharu,Munetsugu Yumi,Kim Sung-Hwan,Shim Jae-Min,Uhm Jae Sun,Im Sung Il,Par Hyoung-Seob,Kim Jun Hyung,On Young Keun,Oh Il-Young,Shin Seung Yong,Ko Jum Suk,Park Jun Beom,Teo Wee-Siong,Won Kelvin Cheok-Keng,Lim Toon-Wei,Foo David,Chen Shih-Ann,Chen Shih-Ann,Chao Tze-Fan,Lin Yenn-Jiang,Chung Fa-Po,Hu Yu-Feng,Chang Shil-Lin,Tuan Ta-Chuan,Liao Jo-Nan,Li Cheng-Hung,Huang Jin-Long,Hsieh Yu-Cheng,Wu Tsu-Juey,Liao Ying-Chieh,Chiang Cheng-Hung,Hsiao Hsiang-Chiang,Yeh Tung-Chen,Lin Wei-Siang,Lin Wen-Yu,Kuo Jen-Yuan,Hong Chong-Lie,Wu Yih-Je,Li Ying-Siang,Tsai Jui-Peng,Sung Kuo-Tzu,Chang Sheng-Hsiung,

Abstract

AbstractWe 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.

Publisher

Springer Science and Business Media LLC

Subject

Multidisciplinary

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