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Updated: Jun 5, 2026
28:13
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Female Sex Is Not a Uniform Risk Factor in Atrial Fibrillation
Cecile McGarvey1, Emma Lunn1, Yishi Jia1
1Tulane Research Innovation for Arrhythmia Discovery, Tulane University School of Medicine, Department of Cardiology, New Orleans, Louisiana, USA.
JACC. Advances
|June 4, 2026
Summary
Female sex modestly modifies stroke risk in atrial fibrillation (AF) patients. The increased risk is mainly seen in women aged 75 and older, especially with more health conditions.
Area of Science:
- Cardiology
- Neurology
- Epidemiology
Background:
- Female sex is considered in stroke risk stratification for atrial fibrillation (AF).
- Emerging data suggest female sex may be a stroke risk modifier, not an independent risk factor in AF patients.
Purpose of the Study:
- To investigate if female sex acts as a risk factor or a risk modifier for stroke in patients with atrial fibrillation (AF).
Main Methods:
- Utilized TriNetX to identify nonvalvular AF patients, stratified by sex and age.
- Propensity matching was performed for comorbidities and anticoagulation between sexes.
- Compared stroke and arterial embolism risks over 1 year in patients with no or one additional CHA2DS2-VA risk factor beyond age.
Main Results:
- In patients without additional risk factors, female sex increased stroke risk only in those aged ≥75 years (HR: 1.244).
- In patients with one additional risk factor, female sex also increased stroke risk for those aged ≥75 years (HR: 1.065).
Conclusions:
- Female sex functions as a modest risk modifier for thromboembolic stroke in AF.
- The elevated stroke risk in females is primarily associated with advanced age (≥75 years) and greater comorbidity burden.
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