title: Gender differences in patients with atrial fibrillation.
abstract: OBJECTIVE
  We aimed to compare gender differences with respect to presentation of consecutive ambulatory patients with atrial fibrillation (AF), management of their disease, and outcomes.
  
  
  METHODS
  Post-hoc analysis of an observational (non-interventional) study performed by 616 office- and hospital-based cardiologists in Germany. Consecutive (mainly ambulatory) patients with Electrocardiography (ECG) -confirmed AF and available data from baseline (BL) and two follow-up visits at 6 and 12 months were assessed.
  
  
  RESULTS
  A total of 2,742 patients (62.8% males, mean age 67.5 years; 37.2% women, mean age 71.2 years) were analysed. Women had more frequently paroxysmal and less frequently permanent AF. Quality of life scores were slightly worse in women compared to men, for all types of AF. For class III anti-arrhythmic drugs at baseline (more frequent in men), and for digitalis (less frequent in men at BL and 1 year) statistically significant differences were noted. Oral anti-coagulation (OAC) without anti-platelet drugs was given in 67.9% at BL and in 62.7% at 1 year (no differences between genders). During follow-up, drug conversions in men/women were reported in 12.3%/14.9% (p=0.054), and electrical conversions in 14.6%/11.7% (p=0.03). Hospitalisations occurred in 25.9% and strokes in 3.5%. Patients with higher CHA2DS2-VASc scores had increased stroke rates (0, 1 and ≥2 points: 0.0, 1.5 and 3.9%, respectively; with no significant gender differences).
  
  
  CONCLUSIONS
  In everyday management of patients with AF, there were no differences in treatment and major outcomes, in particular stroke, between women and men. This finding is opposed to earlier studies reporting OAC undertreatment of women and higher stroke rates.
authors: Cardio Centrum Ludwigsburg, Asperger Str. 48, 71634, Ludwigsburg, Germany. ralph.bosch@kardio-praxis-lb.de
authors: Ralph F
authors: RF
authors: Bosch
authors: David
authors: D
authors: Pittrow
authors: Anne
authors: A
authors: Beltzer
authors: Irmtraut
authors: I
authors: Kruck
authors: Wilhelm
authors: W
authors: Kirch
authors: Annette
authors: A
authors: Kohlhaussen
authors: Hendrik
authors: H
authors: Bonnemeier
mesh_terms: D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D002304:Cardiac Pacing, Artificial / Q000706:statistics & numerical data*; D004554:Electric Countershock / Q000706:statistics & numerical data; D005260:Female; D005858:Germany / Q000453:epidemiology; D015276:Health Care Rationing / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D015995:Prevalence; D011788:Quality of Life; D012307:Risk Factors; D017678:Sex Distribution; D063507:Sexism / Q000706:statistics & numerical data*
chemical_list: D000889:Anti-Arrhythmia Agents
references: Circulation. 1999 Jun 15;99(23):3028-35
references: 10368121
references: J Am Coll Cardiol. 2011 Mar 15;57(11):e101-98
references: 21392637
references: Curr Med Res Opin. 2011 May;27(5):995-1003
references: 21391837
references: Arch Intern Med. 1995 Mar 13;155(5):469-73
references: 7864703
references: J Am Coll Cardiol. 2005 Oct 4;46(7):1307-8
references: 16198848
references: Clin Cardiol. 2012 Jan;35 Suppl 1:21-7
references: 22246948
references: J Am Coll Cardiol. 2011 Jul 26;58(5):493-501
references: 21777747
references: JAMA. 2011 May 25;305(20):2080-7
references: 21610240
references: Card Electrophysiol Rev. 2003 Sep;7(3):276-9
references: 14739727
references: Clin Cardiol. 2013 Jun;36(6):312-22
references: 23568790
references: J Am Coll Cardiol. 2006 Aug 15;48(4):721-30
references: 16904540
references: Am J Med. 1995 May;98(5):476-84
references: 7733127
references: BMJ. 2012 May 30;344:e3522
references: 22653980
references: JAMA. 2012 May 9;307(18):1952-8
references: 22570463
references: Scand J Prim Health Care. 2001 Mar;19(1):20-4
references: 11303542
references: Clin Cardiol. 2012 Dec;35(12):E40-5
references: 23108916
references: JAMA. 1994 Mar 16;271(11):840-4
references: 8114238
references: J Am Coll Cardiol. 2000 Dec;36(7):2242-6
references: 11127467
references: Clin Res Cardiol. 2011 Oct;100(10):897-905
references: 21533828
references: Heart. 2001 Sep;86(3):284-8
references: 11514479
references: Circulation. 2003 Aug 12;108(6):711-6
references: 12885749
references: Eur Heart J. 2001 Oct;22(20):1954-9
references: 11601840
references: Europace. 2009 Apr;11(4):423-34
references: 19153087
references: Europace. 1999 Oct;1(4):226-33
references: 11220559
references: Clin Cardiol. 2013 Feb;36(2):61-7
references: 23338902
references: Eur Heart J. 2005 Nov;26(22):2422-34
references: 16204266
references: N Engl J Med. 2009 Feb 12;360(7):668-78
references: 19213680
references: Dtsch Med Wochenschr. 2010 Mar;135 Suppl 2:S26-32
references: 20221975
references: J Am Coll Cardiol. 2007 Feb 6;49(5):572-7
references: 17276181
references: Am J Med. 1991 Aug;91(2):156-61
references: 1867242
references: Am J Cardiol. 1996 Dec 15;78(12):1380-4
references: 8970410
references: Curr Opin Cardiol. 1999 Jan;14(1):36-43
references: 9932206
references: Int J Cardiol. 2012 Nov 1;161(1):39-44
references: 21570138
references: Circulation. 2003 Jun 17;107(23):2920-5
references: 12771006
references: Br J Gen Pract. 1997 May;47(418):285-9
references: 9219403
references: Arch Intern Med. 1994 Jul 11;154(13):1449-57
references: 8018000
references: JAMA. 2001 May 9;285(18):2370-5
references: 11343485
references: J Am Coll Cardiol. 2005 Oct 4;46(7):1298-306
references: 16198847
references: Am J Cardiol. 2010 Mar 1;105(5):687-93
references: 20185018
references: J Am Coll Cardiol. 2006 Aug 15;48(4):854-906
references: 16904574
references: Am J Cardiol. 2003 Dec 15;92(12):1419-23
references: 14675577
references: Int J Cardiol. 2013 Aug 10;167(3):750-6
references: 22475841
references: Chest. 2010 Feb;137(2):263-72
references: 19762550
references: Eur Heart J. 2010 Oct;31(19):2369-429
references: 20802247
references: Ital Heart J. 2004 Mar;5(3):205-13
references: 15119503
references: Am J Cardiol. 1998 Oct 16;82(8A):82N-85N
references: 9809905
references: Eur Heart J. 2012 Nov;33(21):2719-47
references: 22922413
references: Clin Cardiol. 2013 Feb;36(2):88-95
references: 23338943
references: Circulation. 2004 Aug 31;110(9):1042-6
references: 15313941
references: Am J Cardiol. 1998 Oct 16;82(8A):2N-9N
references: 9809895
references: Am J Cardiol. 1990 May 1;65(16):1112-6
references: 2330896
references: Heart. 2001 Nov;86(5):516-21
references: 11602543
references: JAMA. 2001 Jun 13;285(22):2864-70
references: 11401607
references: Pacing Clin Electrophysiol. 1998 Nov;21(11 Pt 2):2455-8
references: 9825366
references: J Thromb Haemost. 2012 Sep;10(9):1745-51
references: 22805071
references: Circulation. 2001 May 15;103(19):2365-70
references: 11352885
references: Am J Med. 2002 Oct 1;113(5):365-70
references: 12401530