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Updated: Feb 10, 2026
Robotic Ablation of Atrial Fibrillation
Published on: May 29, 2015
Comparing Management and Outcomes in Men and Women With Nonvalvular Atrial Fibrillation: Data From a Population-Based
Yoav Arnson1, Moshe Hoshen2, Adi Berliner Senderey2
1Cardiology Department, Meir Medical Center, Kfar Sava, Israel; Clalit Research Institute, Chief Physician's Office, Clalit Health Services, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel.
Insights
Men and women with atrial fibrillation (AF) have similar stroke risks, though older women face higher risks. Bleeding and mortality risks are generally lower in women with AF, supporting similar anticoagulation strategies.
Area of Science:
- Cardiology
- Epidemiology
- Public Health
Background:
- Inconsistent data exist regarding sex-based differences in thromboembolic risk for patients with atrial fibrillation (AF).
- Understanding these differences is crucial for tailoring effective treatment strategies.
Purpose of the Study:
- To investigate and compare the risks of stroke, mortality, and bleeding between men and women diagnosed with incident atrial fibrillation (AF).
Main Methods:
- A prospective historical cohort study was conducted using electronic health records from a large health maintenance organization.
- Data from 89,213 individuals with incident nonvalvular atrial fibrillation (NVAF) between 2004 and 2015 were analyzed.
- Primary outcomes included ischemic stroke, all-cause mortality, and major bleeding events.
Main Results:
- Women comprised 52.3% of the cohort and were older with more hypertension; men had higher rates of diabetes, heart failure, and ischemic heart disease.
- Overall adjusted stroke risk was similar between sexes (HR: 0.91), but women aged 75+ had increased risk (HR: 1.25).
- Women experienced lower adjusted mortality risk (HR: 0.78) and reduced risks of intracranial hemorrhage (HR: 0.81) and major gastrointestinal bleeding (HR: 0.78).
Conclusions:
- Sex is not an independent predictor of ischemic stroke risk in atrial fibrillation (AF), except in women 75 years and older.
- Lower adjusted mortality and bleeding risks were observed in women with AF.
- Findings suggest that current anticoagulation strategies for stroke prevention can be applied similarly to men and women with AF, considering comparable risk factor profiles.
Objectives:
This study sought to identify the differences in stroke, mortality, and bleeding between men and women with atrial fibrillation (AF).
Background:
There are inconsistent data regarding the thromboembolic risk difference between men and women with AF. The authors assessed the risk of stroke, death, and bleeding in men and women with incident AF.
Methods:
The authors employed a prospective historical cohort using an electronic database from a large health maintenance organization. All members with incident AF between 2004 and 2015 were included. Primary endpoints were ischemic stroke, death, and major bleeding.
Results:
The authors identified 89,213 members with incident nonvalvular atrial fibrillation (NVAF), 52.3% of whom were women. Women were older, with a higher prevalence of hypertension, whereas more men had diabetes, heart failure, and ischemic heart disease than the women did. Ischemic stroke occurred in 6.4% of the patients: 7.0% of women and 5.8% of men. Sex did not affect adjusted stroke risk (hazard ratio [HR]: 0.91; 95% confidence interval [CI]: 0.77 to 1.06; p = 0.22). However, women 75 years of age and older were at an increased risk (HR: 1.25; 95% CI: 1.17 to 1.34). Mortality rates were higher among women (33.5% vs. 32%; p < 0.001); however, women had a significantly lower adjusted mortality risk (HR: 0.78; 95% CI: 0.71 to 0.86). Women had lower risk of intracranial hemorrhage (HR: 0.81; 95% CI: 0.76 to 0.87) and major gastrointestinal bleeding (HR: 0.78; 95% CI: 0.70 to 0.87).
Conclusions:
Men and women with AF had a similar risk of ischemic stroke, except for women 75 years of age or older, who had a higher risk. Our findings support using a similar anticoagulation strategy for prevention of stroke in men and women with a similar number of risk factors.
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