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

Tommaso Bucci, Alena Shantsila, Giulio Francesco Romiti, Wee Siong Teo, Hyung Wook Park, Wataru Shimizu, Davide Antonio Mei, Hung Fat Tse, Marco Proietti, Tze Fan Chao, Gregory Y.H. Lip, Chun Wah Siu David, Wataru Shimizu, Kenji Yodogawa, Hiroyuki Tsutsui, Yasushi Mukai, Hirofumi Tomita, Daisuke Horiuchi, Joji Hagii, Kazutaka AonumaYasuo Okumura, Masahiko Goya, Kenzo Hirao, Masayoshi Ajioka, Nobuhisa Hagiwara, Atsushi Suzuki, Teiichi Yamane, Takanori Ikeda, Hitomi Yuzawa, Kazuhiro Satomi, Yoshinao Yazaki, Keiichi Fukuda, Yoshinori Kobayashi, Norishige Morita, Toyoaki Murohara, Eiichi Watanabe, Masahide Harada, Satoru Sakagami, Takahiro Saeki, Kengo Kusano, Koji Miyamoto, Shinsuke Miyazaki, Hiroshi Tada, Koichi Inoue, Nobuaki Tanaka, Yukihiro Koretsune, Haruhiko Abe, Yasuki Kihara, Yukiko Nakano, Akihiko Shimizu, Yasuhiro Yoshiga, Tomohiro Sakamoto, Ken Okumur, Naohiko Takahashi, Tetsuji Shinohara, Kyoko Soejima, Masahiko Takagi, Mitsuharu Kawamura, Yumi Munetsugu, Sung Hwan Kim, Jae Min Shim, Jae Sun Uhm, Sung Il Im, Hyoung Seob Par, Jun Hyung Kim, Young Keun On, Il Young Oh, Seung Yong Shin, Jum Suk Ko, Jun Beom Park, Wee Siong Teo, Kelvin Cheok Keng Won, Toon Wei Lim, David Foo, Shih Ann Chen, Tze Fan Chao, Yenn Jiang Lin, Fa Po Chung, Yu Feng Hu, Shil Lin Chang, Ta Chuan Tuan, Jo Nan Liao, Cheng Hung Li, Jin Long Huang, Yu Cheng Hsieh, Tsu Juey Wu, Ying Chieh Liao, Hsiang Chiang Hsiao, Tung Chen Yeh, Wei Siang Lin, Wen Yu Lin, Jen Yuan Kuo, Chong Lie Hong, Yih Je Wu, Ying Siang Li, Jui Peng Tsai, Kuo Tzu Sung, Sheng Hsiung Chang

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3 Scopus citations

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.

Original languageEnglish
Article number18375
JournalScientific Reports
Volume13
Issue number1
DOIs
StatePublished - Dec 2023

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© 2023, The Author(s).

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