We 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.
Sex-related differences in presentation, treatment, and outcomes of Asian patients with atrial fibrillation: a report from the prospective APHRS-AF Registry / 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.; Null, Null; 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. - In: SCIENTIFIC REPORTS. - ISSN 2045-2322. - 13:1(2023), pp. 18375-18375. [10.1038/s41598-023-45345-3]
Sex-related differences in presentation, treatment, and outcomes of Asian patients with atrial fibrillation: a report from the prospective APHRS-AF Registry
Mei, Davide Antonio;Proietti, Marco;
2023
Abstract
We 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.
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