Key result
Women with non-valvular atrial fibrillation had higher anticoagulant use than men (74.5% vs. 69.9%; p<0.001), though 25.3% of high-risk women and 30.5% of high-risk men remained untreated.
Why the study?
Are there gender-related differences in the presentation and treatment of patients with non-valvular atrial fibrillation?
Are there gender-related differences in the presentation and treatment of patients with non-valvular atrial fibrillation?
In Turkish outpatients with non-valvular AF, women have higher rates of anticoagulation than men, but both genders show significant underuse in high-risk patients and overuse in low-risk patients.
OBJECTIVE: Gender is an important feature in the management of atrial fibrillation (AF). This study investigated gender-related differences in patients with AF in Turkey. METHODS: As a part of RAMSES (ReAl-life Multicenter Survey Evaluating Stroke prevention strategies in Turkey, NCT02344901) study, information of the patients with AF who successively applied to the hospital was analyzed. This cross-sectional, multicenter, nationwide observational study enrolled 6264 non-valvular AF (NVAF) outpatients (55.9% women) from Turkey. RESULTS: Compared with men, women with NVAF were older (71 years [range: 65-78 years] vs. 70 years [range: 62-77 years]; p<0.001), had lower frequency of coronary artery disease (22.0% vs. 38.3%; p<0.001) and congestive heart failure (18.2% vs. 27.2%; p<0.001). Women had higher median CHA2DS2-VASc score (4 [range: 3-5] vs. 3 [range: 2-4]; p<0.001), but similar HAS-BLED score (2 [range: 1-2] vs. 2 [range: 1-2]; p=0.141) when compared with men. Anticoagulant therapy use was higher in women (74.5% vs. 69.9%; p<0.001). Analysis of anticoagulation therapy use revealed that 68.5% of men and 61.6% of women (p=0.204) who had low risk for stroke (CHA2DS2-VASc score: 0 [male], 1 [female]) received anticoagulation therapy, and 30.5% of the men. Meanwhile, 25.3% of the women (p<0.001) with high risk for stroke (CHA2DS2-VASc score: ≥1 [male], ≥2 [female]) had not received any anticogulant therapy. CONCLUSION: Although women with NVAF receive better treatment than men, anticoagulation therapy is suboptimal in large proportion of men and women, with underuse in high-risk patients and overuse in low-risk patients. There is an urgent need to improve optimization of anticoagulation in patients with NVAF.
No takes yet. Share an insight, caveat, or question.
Volkan Doğan (2016) studied this question. Women with non-valvular atrial fibrillation had higher anticoagulant use than men (74.5% vs. 69.9%; p<0.001), though 25.3% of high-risk women and 30.5% of high-risk men remained untreated.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: