Sex-related differences in presentation, treatment, and outcomes of Asian patients with atrial fibrillation: a report from the prospective APHRS-AF Registry.


Bucci, Tommaso ORCID: 0000-0003-2895-6234, Shantsila, Alena ORCID: 0000-0002-0594-8576, Romiti, Giulio Francesco, Teo, Wee-Siong, Park, Hyung-Wook, Shimizu, Wataru, Mei, Davide Antonio, Tse, Hung-Fat, Proietti, Marco ORCID: 0000-0003-1452-2478, Chao, Tze-Fan et al (show 2 more authors) (2023) Sex-related differences in presentation, treatment, and outcomes of Asian patients with atrial fibrillation: a report from the prospective APHRS-AF Registry. Scientific reports, 13 (1). 18375-.

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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.

Item Type: Article
Uncontrolled Keywords: Asia-Pacific Heart Rhythm Society Atrial Fibrillation Registry Investigators, Humans, Atrial Fibrillation, Hemorrhage, Anticoagulants, Registries, Risk Factors, Prospective Studies, Aged, Middle Aged, Female, Male, Stroke
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences
Depositing User: Symplectic Admin
Date Deposited: 02 Nov 2023 09:31
Last Modified: 11 Nov 2023 01:15
DOI: 10.1038/s41598-023-45345-3
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3176488
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