Gender-related differences in presentation, treatment, and outcome of patients with atrial fibrillation in Europe - A report from the Euro Heart Survey on atrial fibrillation

Dagres, N., Nieuwlaat, R., Vardas, P., Andresen, D., Levy, S., Cobbe, S., Kremastinos, D., Breithardt, G., Cokkinos, D. and Crijns, H. (2007) Gender-related differences in presentation, treatment, and outcome of patients with atrial fibrillation in Europe - A report from the Euro Heart Survey on atrial fibrillation. Journal of the American College of Cardiology, 49(5), pp. 572-577. (doi: 10.1016/j.jacc.2006.10.047)

Abstract

Objectives This study sought to investigate gender-related differences in patients with atrial fibrillation (AF) in Europe. Background Gender-related differences may play a significant role in AF. Methods We analyzed the data of 5,333 patients (42% female) enrolled in the Euro Heart Survey on Atrial Fibrillation. Results Compared with men, the women were older, had a lower quality of life (QoL), had more comorbidities, more often had heart failure (HF) with preserved left ventricular systolic function (18% vs. 7%, p < 0.001), and less often had HF with systolic dysfunction (17% vs. 26%, p < 0.001). Among patients with typical AF symptoms (56% of women, 49% of men), there was no gender-related difference in the choice of rate or rhythm control. Among patients with atypical or no symptoms (44% of women, 51% of men), women less frequently underwent rhythm control (39% vs. 51%, p < 0.001) than did men. Women underwent less electrical cardioversion (22% vs. 28%, p < 0.001). Prescription of oral anticoagulants was identical (65%) in both genders. One-year outcome was similar except that women had a higher chance for stroke (odds ratio 1.83 in multivariable regression analysis, p = 0.019). Conclusions Women with AF had more comorbidities, more HF with preserved systolic function, and a lower QoL than men. In the large group with atypical or no symptoms, women were treated appropriately more conservatively with less rhythm control than men. Women had a higher chance for stroke. Long-term QoL changes and other morbidities and mortality were similar.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Cobbe, Professor Stuart
• Authors: Dagres, N., Nieuwlaat, R., Vardas, P., Andresen, D., Levy, S., Cobbe, S., Kremastinos, D., Breithardt, G., Cokkinos, D., and Crijns, H.
• College/School: College of Medical Veterinary and Life Sciences
• Journal Name: Journal of the American College of Cardiology
• Publisher: Elsevier Inc.
• ISSN: 0735-1097