Sex Differences in Presentation, Quality of Life, and Treatment in Chinese Atrial Fibrillation Patients: Insights from the China Atrial Fibrillation Registry Study

Sex Differences in Presentation, Quality of Life, and Treatment in Chinese Atrial Fibrillation Patients: Insights from the China Atrial Fibrillation Registry Study
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中国房颤患者在表现、生活质量和治疗方面的性别差异:来自中国房颤登记研究的见解

DOI:
10.12659/msm.919366
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发表时间:
2019-10-25
影响因子:
3.1
通讯作者:
Ma, Chang-Sheng
Ma, Chang-Sheng
中科院分区:
医学4区
文献类型:
--
作者:
Li, Yan-Ming;Jiang, Chao;Ma, Chang-Sheng

文献摘要

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背景:越来越多的人认识到心房颤动(AF)的性别差异。然而,中国AF患者的可用数据有限。材料/方法我们比较了中国房颤登记研究中不同性别房颤患者的症状、生活质量(QoL)和治疗。结果14723例非瓣膜性房颤患者中,女性5645例(38.3%)。女性年龄大于男性(67.5±10.6 vs. 62.2±12.2)。与男性相比,女性有更多的合并症和较高比例的CHA 2DS 2-VASC评分≥2。女性房颤患者出现严重或致残症状的比例高于男性(<75岁组33.7% vs. 22.9%; ≥75岁组40.3% vs. 28.7%;均P<0.0001)。多因素分析后,AF患者的生活质量仍较低(OR 0.69; 95%CI 0.63-0.76; P<0.0001)。在年龄<75岁的女性中,消融和节律控制药物的使用率往往较低。在CHA 2DS 2-VASC评分≥2的AF患者中,口服抗凝剂的使用率较低,且无性别差异。结论在中国房颤患者中,女性年龄较大,症状更多,生活质量较差。尽管存在这些差异,但年龄<75岁的女性倾向于接受较少的节律控制治疗。口服抗凝剂在高卒中风险患者中的使用严重不足,无论性别如何。
Background There is a growing recognition of sex-related disparities in atrial fibrillation (AF). However, limited data is available in Chinese AF patients. Material/Methods We compared symptoms, quality of life (QoL), and treatment of AF according to sex from the China AF Registry study. Results We studied 14 723 patients with non-valvular AF, of whom 5645 patients (38.3%) were female. Women were older than men (67.5±10.6 vs. 62.2±12.2). Compared to men, women had more comorbidities and a higher proportion of CHA2DS2-VASC score ≥2. Women with AF experienced more severe or disabling symptoms than men (33.7% vs. 22.9% in age <75 group; 40.3% vs. 28.7% in age ≥75 group; both P<0.0001). After multivariate analysis, women with AF still had lower QoL (OR 0.69; 95%CI, 0.63–0.76; P<0.0001). Women tended to have lower rates of ablation and rhythm-control drug use in those aged <75 years. Oral anticoagulant use was low and had no sex difference in AF patients with a CHA2DS2-VASC score ≥2. Conclusions In Chinese AF patients, women were older and more symptomatic, and had worse QoL. Despite all these differences, women tended to receive less rhythm-control treatment in those aged <75 years. Oral anticoagulant was substantially underused in high stroke risk patients, regardless of sex.