What question did this study set out to answer?

To evaluate linear and nonlinear associations between female-specific reproductive factors and the risk of developing new-onset atrial fibrillation.

September 1, 2022JAMA Network OpenOpen Access

Association Between Sex-Specific Risk Factors and Risk of New-Onset Atrial Fibrillation Among Women

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Why the study?

AF has different epidemiology, pathophysiology, and poorer prognosis in women vs men, warranting further investigation of sex-specific risk factors for AF development in women.

Are sex-specific reproductive risk factors associated with an increased risk of new-onset atrial fibrillation in women?

Key Points

To evaluate linear and nonlinear associations between female-specific reproductive factors and the risk of developing new-onset atrial fibrillation.
Analyzed data from 235,191 women (mean age 55.7 years) without baseline atrial fibrillation, hysterectomy, or bilateral oophorectomy in the UK Biobank study.
Assessed self-reported reproductive exposures—including age at menarche, menstrual cycle regularity, menopausal status and timing, and live birth history—over a median follow-up of 11.6 years.
Identified primary incident atrial fibrillation events using International Statistical Classification of Diseases, Tenth Revision (ICD-10) diagnosis code I48.
Over median follow-up, 4,629 of 235,191 women (2.0%) developed new-onset atrial fibrillation.
Higher atrial fibrillation risk occurred with irregular menstrual cycles (HR 1.34; 95% CI, 1.01-1.79), early menarche (HR 1.10; 95% CI, 1.00-1.21), late menarche (HR 1.08; 95% CI, 1.00-1.17), early menopause (HR 1.24; 95% CI, 1.10-1.39), and delayed menopause (HR 1.34; 95% CI, 1.10-1.78).
Compared with women with 1 to 2 live births, significantly elevated risk was documented in nulliparous women (0 live births: HR 1.13; 95% CI, 1.04-1.24) and grand multiparous women (≥7 live births: HR 1.67; 95% CI, 1.03-2.70).

Structured PICO

Are sex-specific reproductive risk factors associated with an increased risk of new-onset atrial fibrillation in women?

Population

235,191 women aged 40 to 69 years (mean age 55.7) without atrial fibrillation and without a history of hysterectomy and/or bilateral oophorectomy at baseline, from the UK Biobank study.

Intervention

Presence of sex-specific reproductive risk factors (including irregular menstrual cycle, early/late menarche, early/delayed menopause, nulliparity, and multiparity).

Comparator

Absence of these specific reproductive risk factors (e.g., regular menstrual cycles, normal age of menarche/menopause, 1 to 2 live births).

Outcome

New-onset atrial fibrillation (defined by ICD-10 code I48).hard clinical

Discussion

No takes yet. Share an insight, caveat, or question.

Implication

May inform AF risk assessment in women; hypothesis-generating for reproductive factor-targeted prevention trials.

Cite This Study

Lu et al. (2022) studied this question.

synapsesocial.com/papers/6a6fbb3b8031ec7bb1dbea65 https://doi.org/10.1001/jamanetworkopen.2022.29716

Topics

Atrial fibrillation Persistent AF management

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Association Between Sex-Specific Risk Factors and Risk of New-Onset Atrial Fibrillation Among Women

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Topics

Association Between Sex-Specific Risk Factors and Risk of New-Onset Atrial Fibrillation Among Women

Key Points

Structured PICO

Discussion

Implication

Cite This Study

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Topics

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