Key result
Female sex is linked to ~24% higher 1-year mortality versus males after ischemic stroke.
Why the study?
The study was designed to examine sex differences in disease profiles, management, and survival at 1 and 5 years after ischemic stroke among patients with atrial fibrillation.
Are there sex differences in disease profiles, management, and survival at 1 and 5 years after ischemic stroke among people with atrial fibrillation?
Meta-Analysis (n=1,862)
Yes
Are there sex differences in disease profiles, management, and survival at 1 and 5 years after ischemic stroke among people with atrial fibrillation?
Women with atrial fibrillation after an ischemic stroke have a higher crude mortality rate at 1 and 5 years compared to men.
Women with AF post-stroke may warrant closer monitoring; leaves open whether sex differences persist after adjustment or guide therapy.
Objectives: To examine sex differences in disease profiles, management, and survival at 1 and 5 years after ischemic stroke (IS) among people with atrial fibrillation (AF). Methods: We performed a systematic literature search of reports of AF at IS onset according to sex. We undertook an individual participant data meta-analysis (IPDMA) of nine population-based stroke incidence studies conducted in Australasia, Europe, and South America (1993-2014). Poisson regression was used to estimate women:men mortality rate ratios (MRRs). Study-specific MRRs were combined using random effects meta-analysis. Results: In our meta-analysis based on aggregated data from 101 studies, the pooled AF prevalence was 23% (95% confidence interval [CI]: 22%-25%) in women and 17% (15%-18%) in men. Our IPDMA is of 1,862 IS-AF cases, with women (79.2 -9.1, years) being older than men (76.5 -9.5, years). Crude pooled mortality rate was greater for women than for men (1-year MRR 1.24; 1.01-1.51; 5-year 1.12; 1.03-1.22). However, the sex difference
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Wang et al. (2020) conducted a meta-analysis in Ischemic stroke with atrial fibrillation (n=1,862). Female sex vs. Male sex was evaluated on 1-year mortality (MRR 1.24, 95% CI 1.01-1.51). Female sex was associated with higher crude pooled mortality rates compared to male sex at 1 year (MRR 1.24; 95% CI 1.01-1.51) and 5 years (MRR 1.12; 95% CI 1.03-1.22) after ischemic stroke.
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