Gender differences in clinical presentation and 1-year outcomes in atrial fibrillation.
Gender differences in clinical presentation and 1-year outcomes in atrial fibrillation.
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DOI：
10.1136/heartjnl-2016-310406
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发表时间：
2017-07
期刊：
影响因子：
--
通讯作者：
Kirchhof P
中科院分区：
文献类型：
--
作者：
Schnabel RB;Pecen L;Ojeda FM;Lucerna M;Rzayeva N;Blankenberg S;Darius H;Kotecha D;Caterina R;Kirchhof P
我们的目的是研究当代队列中房颤（AF）的临床表现、治疗和预后的性别差异。在欧洲房颤血栓栓塞事件预防登记的6412例患者中，39.7%为女性，我们检查了症状、危险因素、治疗和1年不良结局发生率的性别差异。男性房颤患者平均比女性年轻（平均±SD: 70.1±10.7 vs 74.1±9.7岁，p<0.0001）。与男性相比，女性更频繁地出现至少一种af相关症状（女性为95.4%，男性为89.8%,p<0.0001）。口服抗凝剂处方相似，非维生素K拮抗剂口服抗凝剂在女性中从5.9%增加到12.6%，在男性中从6.2%增加到12.6%，两者的p<0.0001。男性接受电转复和消融治疗的频率（分别为20.6%和6.3%）高于女性（分别为14.9%和3.3%），p<0.0001。女性经年龄调整和国家调整的冠状动脉血运重建的几率降低65% (OR: 0.35; 95% CI(0.22至0.56))，急性冠状动脉综合征的几率降低40% (OR: 0.60;(0.38至0.93))，1年后心力衰竭的几率降低20% （OR: 0.80;(0.68至0.96)）。1年内卒中/短暂性缺血发作/动脉血栓栓塞和大出血事件的性别差异无统计学意义。在“真实世界”的欧洲房颤登记中，女性更有症状，但更不可能接受侵入性心律控制治疗，如电转复或消融。需要进一步的研究来证实这些差异并不会对患有房颤的女性不利。
Our objective was to examine gender differences in clinical presentation, management and prognosis of atrial fibrillation (AF) in a contemporary cohort. In 6412 patients, 39.7% women, of the PREvention oF thromboembolic events – European Registry in Atrial Fibrillation, we examined gender differences in symptoms, risk factors, therapies and 1-year incidence of adverse outcomes. Men with AF were on average younger than women (mean±SD: 70.1±10.7 vs 74.1±9.7 years, p<0.0001). Women more frequently had at least one AF-related symptom at least occasionally compared with men (95.4% in women, 89.8% in men, p<0.0001). Prescription of oral anticoagulation was similar, with an increase of non-vitamin K antagonist oral anticoagulants from 5.9% to 12.6% in women and from 6.2% to 12.6% in men, p<0.0001 for both. Men were more frequently treated with electrical cardioversion and ablation (20.6% and 6.3%, respectively) than women (14.9% and 3.3%, respectively), p<0.0001. Women had 65% (OR: 0.35; 95% CI (0.22 to 0.56)) lower age-adjusted and country-adjusted odds of coronary revascularisation, 40% (OR: 0.60; (0.38 to 0.93)) lower odds of acute coronary syndrome and 20% (OR: 0.80; (0.68 to 0.96)) lower odds of heart failure at 1 year. There were no statistically significant gender differences in 1-year stroke/transient ischaemic attack/arterial thromboembolism and major bleeding events. In a ‘real-world’ European AF registry, women were more symptomatic but less likely to receive invasive rhythm control therapy such as electrical cardioversion or ablation. Further study is needed to confirm that these differences do not disadvantage women with AF.
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影响因子：
39
作者：
Soliman, Elsayed Z.;Safford, Monika M.;Muntner, Paul;Khodneva, Yulia;Dawood, Farah Z.;Zakai, Neil A.;Thacker, Evan L.;Judd, Suzanne;Howard, Virginia J.;Howard, George;Herrington, David M.;Cushman, Mary
通讯作者：
Cushman, Mary
影响因子：
5.7
作者：
DeWilde, S.;Carey, I. M.;Cook, D. G.
通讯作者：
Cook, D. G.
影响因子：
24
作者：
Blomkalns, AL;Chen, AY;Newby, LK
通讯作者：
Newby, LK
影响因子：
6.1
作者：
Kirchhof, Paulus;Benussi, Stefano;Zeppenfeld, Katja
通讯作者：
Zeppenfeld, Katja
影响因子：
105.7
作者：
Emdin, Connor A.;Wong, Christopher X.;Odutayo, Ayodele A.
通讯作者：
Odutayo, Ayodele A.