Outcome of men and women after atrial fibrillation and stroke

Area of Science:

• Cardiology
• Neurology
• Epidemiology

Background:

• Atrial fibrillation (AF) is a significant risk factor for ischemic stroke.
• Understanding long-term outcomes after stroke in AF patients is crucial for effective management.
• Gender-based differences in stroke risk, treatment, and outcomes require investigation.

Purpose of the Study:

• To compare the long-term outcomes of men and women following an ischemic stroke related to atrial fibrillation.
• To analyze differences in dependence, disability, risk factors, mortality, and stroke prophylaxis between genders.

Main Methods:

• A cohort of 155 patients (94 women, 61 men) with AF-related ischemic stroke was followed for 1 and 5 years.
• Assessment included the Barthel Index for dependence and the modified Rankin Scale for disability.
• Data on risk factors, mortality, and stroke prophylaxis (warfarin, NOACs) before and after stroke were collected and compared between genders.

Main Results:

• No significant gender difference in 5-year mortality was observed (76% women, 73% men deceased).
• After 1 year, approximately half of both men and women were independent; after 5 years, half of men but only a third of women remained independent.
• Women were less frequently prescribed warfarin before stroke (11% vs. 28%), though anticoagulant use increased for both genders post-discharge.

Conclusions:

• Long-term mortality after AF-related ischemic stroke does not differ significantly between men and women.
• Men were prescribed anticoagulants more frequently prior to stroke, suggesting potential gender-based disparities in preventative treatment.
• Further research is warranted to explore these gender-based differences in anticoagulant prescription and stroke prevention strategies.