Gender-related differences in presentation, treatment, and outcome of patients with atrial fibrillation in Europe: a report from the Euro Heart Survey on Atrial Fibrillation.
OBJECTIVE
This study sought to investigate gender-related differences in patients with atrial fibrillation (AF) in Europe.


BACKGROUND
Gender-related differences may play a significant role in AF.


METHODS
We analyzed the data of 5,333 patients (42% female) enrolled in the Euro Heart Survey on Atrial Fibrillation.


RESULTS
Compared with men, the women were older, had a lower quality of life (QoL), had more comorbidities, more often had heart failure (HF) with preserved left ventricular systolic function (18% vs. 7%, p < 0.001), and less often had HF with systolic dysfunction (17% vs. 26%, p < 0.001). Among patients with typical AF symptoms (56% of women, 49% of men), there was no gender-related difference in the choice of rate or rhythm control. Among patients with atypical or no symptoms (44% of women, 51% of men), women less frequently underwent rhythm control (39% vs. 51%, p < 0.001) than did men. Women underwent less electrical cardioversion (22% vs. 28%, p < 0.001). Prescription of oral anticoagulants was identical (65%) in both genders. One-year outcome was similar except that women had a higher chance for stroke (odds ratio 1.83 in multivariable regression analysis, p = 0.019).


CONCLUSIONS
Women with AF had more comorbidities, more HF with preserved systolic function, and a lower QoL than men. In the large group with atypical or no symptoms, women were treated appropriately more conservatively with less rhythm control than men. Women had a higher chance for stroke. Long-term QoL changes and other morbidities and mortality were similar.
Dagres
Nikolaos
N
University of Athens, Second Cardiology Department, Attikon University Hospital, Athens, Greece. nikolaosdagres@yahoo.de
Nieuwlaat
Robby
R
Vardas
Panos E
PE
Andresen
Dietrich
D
Lévy
Samuel
S
Cobbe
Stuart
S
Kremastinos
Dimitrios Th
DT
Breithardt
Günter
G
Cokkinos
Dennis V
DV
Crijns
Harry J G M
HJ
D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000150:complications* / Q000175:diagnosis / Q000628:therapy*; D005060:Europe; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006306:Health Surveys; D006333:Heart Failure / Q000150:complications; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012737:Sex Factors; D020521:Stroke / Q000209:etiology; D016896:Treatment Outcome