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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
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Sex differences in stroke risk among older patients with recently diagnosed atrial fibrillation

Meytal Avgil Tsadok1, Cynthia A Jackevicius, Elham Rahme

  • 1Division of Clinical Epidemiology, McGill University Health Center, Montreal, Quebec, Canada.

JAMA
|May 10, 2012
PubMed

Insights

Women with atrial fibrillation (AF) face a higher stroke risk than men, even with similar warfarin use. This study found women had a greater risk of stroke, particularly those aged 75 and older.

Area of Science:

  • Cardiology
  • Geriatrics
  • Public Health

Background:

  • Atrial fibrillation (AF) significantly increases stroke risk.
  • Women with AF exhibit a higher stroke risk compared to men.
  • The reasons for this disparity, potentially including warfarin undertreatment, are not fully understood.

Purpose of the Study:

  • To compare warfarin utilization and subsequent stroke risk in older men and women with AF.
  • To investigate population-level differences in stroke risk between sexes in AF patients.

Main Methods:

  • A population-based cohort study utilizing administrative data from Quebec, Canada (1998-2007).
  • Included patients aged 65+ hospitalized with newly diagnosed AF.
  • Linked hospital discharge, physician, and prescription drug claims data.

Main Results:

  • The study included 39,398 men and 44,115 women; women were older and had higher CHADS(2) scores.
  • Warfarin prescription filling rates were similar, with slightly higher rates in women (60.6% vs 58.2%).
  • Women had a significantly higher crude and adjusted risk of stroke (aHR, 1.14; P < .001), especially those ≥75 years.

Conclusions:

  • Older women with recently diagnosed AF face a greater stroke risk than men.
  • This increased risk persists regardless of warfarin use, suggesting other factors contribute.
  • The findings highlight a critical sex-based disparity in stroke risk among AF patients.
Abstract

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