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Diferencias de sexo en el riesgo de accidente cerebrovascular entre pacientes mayores con fibrilación auricular
Meytal Avgil Tsadok1, Cynthia A Jackevicius, Elham Rahme
1Division of Clinical Epidemiology, McGill University Health Center, Montreal, Quebec, Canada.
JAMA
|May 10, 2012
Resumen
Las mujeres con fibrilación auricular (FA) se enfrentan a un mayor riesgo de accidente cerebrovascular que los hombres, incluso con un uso similar de warfarina. Este estudio encontró que las mujeres tenían un mayor riesgo de accidente cerebrovascular, particularmente aquellas de 75 años o más.
Área de la Ciencia:
- Cardiología Cardiología.
- Geriatría La geriatría es la especialidad de la geriatría.
- Salud Pública La salud pública.
Sus antecedentes:
- La fibrilación auricular (FA) aumenta significativamente el riesgo de accidente cerebrovascular.
- Las mujeres con FA presentan un mayor riesgo de accidente cerebrovascular en comparación con los hombres.
- Las razones de esta disparidad, que potencialmente incluyen el subtratamiento con warfarina, no se comprenden completamente.
Objetivo del estudio:
- Para comparar la utilización de warfarina y el riesgo de accidente cerebrovascular subsiguiente en hombres y mujeres mayores con FA.
- Para investigar las diferencias a nivel de población en el riesgo de accidente cerebrovascular entre los sexos en pacientes con AF.
Principales métodos:
- Un estudio de cohorte basado en la población utilizando datos administrativos de Quebec, Canadá (1998-2007).
- Se incluyeron pacientes mayores de 65 años hospitalizados con AF recién diagnosticada.
- Datos de reclamos de alta hospitalaria, médico y medicamentos recetados vinculados.
Principales resultados:
- El estudio incluyó a 39.398 hombres y 44.115 mujeres; las mujeres eran mayores y tenían puntuaciones más altas de CHADS.
- Las tasas de llenado de recetas de warfarina fueron similares, con tasas ligeramente más altas en las mujeres (60,6% frente a 58,2%).
- Las mujeres tenían un riesgo de accidente cerebrovascular crudo y ajustado significativamente mayor (aHR, 1.14; P < .001), especialmente aquellas ≥75 años.
Conclusiones:
- Las mujeres mayores con FA recientemente diagnosticada enfrentan un mayor riesgo de accidente cerebrovascular que los hombres.
- Este aumento del riesgo persiste independientemente del uso de warfarina, lo que sugiere que otros factores contribuyen.
- Los hallazgos destacan una disparidad crítica basada en el sexo en el riesgo de accidente cerebrovascular entre los pacientes con AF.
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