Key result
Male patients with non-valvular atrial fibrillation had a significantly higher 5-year survival rate than females (77.1% vs. 71.5%) and a lower adjusted risk of all-cause mortality (HR 0.89).
Why the study?
Clinical and epidemiological differences exist between men and women with AF, but contemporary population-level data on incidence and survival are scarce.
Observational (n=15,409)
Hazard Ratio: 0.89 (95% CI 0.82–0.96)
Absolute Event Rate: 77.1% vs 71.5%
p-value: p=0.002
Between 2007 and 2015 in Israel, the incidence of non-valvular AF decreased in both sexes, but prevalence increased in men and decreased in women, with women showing a significant trend toward improved long-term survival.
Sex disparities in AF incidence and survival persist; leaves open mechanistic and interventional research needs.
INTRODUCTION: Atrial fibrillation (AF) is a major increasing public health problem worldwide, with clinical and epidemiological differences between men and women. However, contemporary population-level data on incidence and survival are scarce. AIM: To evaluate sex-specific contemporary trends in the incidence, prevalence, and long-term survival of non-valvular AF in a real-world setting. METHODS: AF patients diagnosed between 2007-2015, insured by a large, state-mandated health organization in Israel (Maccabi Healthcare Services) were included. AF was diagnosed based on registered diagnoses. Patients with valvular disease, active malignancy, cardiac surgery ≤ 6 months, or recent pregnancy, were excluded. Annual incidence rate, period prevalence, and 5-year survival for each calendar year during the study period, were calculated. RESULTS: A total of 15,409 eligible patients (8,288 males, 7,121 females) were identified. Males were more likely to be younger, have higher rates of underlying diseases (ischemic heart disease, heart failure, and chronic obstructive pulmonary disease), but with lower rates of hypertension and chronic kidney diseases as compared to female patients. During the study period, age-adjusted incidence decreased both in men: (-0.020/1,000-person year, p-for trend = 0.033) and, women (-0.025/1,000 person-year p = 0.009). The five-year survival rate was significantly higher among men vs. women (77.1% vs. 71.5%, respectively, p<0.001). Age-adjusted prevalence increased significantly among men (+0.102 per year, p-for trend<0.001) yet decreased among women (-0.082 per year, p-for trend = 0.005). A significant trend toward improved long-term survival was observed in women and not in men. CONCLUSIONS: The current study shows significant sex-related disparities in the incidence, prevalence, and survival of AF patients between 2007-2015; while the adjusted incidence of both has decreased over-time, prevalence and mortality decreased significantly only in women.
No takes yet. Share an insight, caveat, or question.
Shiyovich et al. (2021) conducted an observational in Non-valvular atrial fibrillation (n=15,409). Male sex vs. Female sex was evaluated on 5-year survival and all-cause mortality (HR 0.89, 95% CI 0.82-0.96, p=0.002). Male patients with non-valvular atrial fibrillation had a significantly higher 5-year survival rate than females (77.1% vs. 71.5%) and a lower adjusted risk of all-cause mortality (HR 0.89).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: