title: Gender-related differences in presentation and treatment of patients with non-valvular atrial fibrillation: results from RAMSES study.
abstract: OBJECTIVE
  Gender is an important feature in the management of atrial fibrillation (AF). This study investigated gender-related differences in patients with AF in Turkey.
  
  
  METHODS
  As a part of RAMSES (ReAl-life Multicenter Survey Evaluating Stroke prevention strategies in Turkey, NCT02344901) study, information of the patients with AF who successively applied to the hospital was analyzed. This cross-sectional, multicenter, nationwide observational study enrolled 6264 non-valvular AF (NVAF) outpatients (55.9% women) from Turkey.
  
  
  RESULTS
  Compared with men, women with NVAF were older (71 years [range: 65-78 years] vs. 70 years [range: 62-77 years]; p<0.001), had lower frequency of coronary artery disease (22.0% vs. 38.3%; p<0.001) and congestive heart failure (18.2% vs. 27.2%; p<0.001). Women had higher median CHA2DS2-VASc score (4 [range: 3-5] vs. 3 [range: 2-4]; p<0.001), but similar HAS-BLED score (2 [range: 1-2] vs. 2 [range: 1-2]; p=0.141) when compared with men. Anticoagulant therapy use was higher in women (74.5% vs. 69.9%; p<0.001). Analysis of anticoagulation therapy use revealed that 68.5% of men and 61.6% of women (p=0.204) who had low risk for stroke (CHA2DS2-VASc score: 0 [male], 1 [female]) received anticoagulation therapy, and 30.5% of the men. Meanwhile, 25.3% of the women (p<0.001) with high risk for stroke (CHA2DS2-VASc score: ≥1 [male], ≥2 [female]) had not received any anticogulant therapy.
  
  
  CONCLUSIONS
  Although women with NVAF receive better treatment than men, anticoagulation therapy is suboptimal in large proportion of men and women, with underuse in high-risk patients and overuse in low-risk patients. There is an urgent need to improve optimization of anticoagulation in patients with NVAF.
authors.affiliation: Department of Cardiology, Muğla Sıtkı Koçman University Faculty of Medicine, Muğla, Turkey. drvolkandogan@hotmail.com.
authors.forename: Volkan
authors.initials: V
authors.lastname: Doğan
authors.forename: Özcan
authors.initials: Ö
authors.lastname: Başaran
authors.forename: Osman
authors.initials: O
authors.lastname: Beton
authors.forename: Mehmet
authors.initials: M
authors.lastname: Tekinalp
authors.forename: Ahmet Çağrı
authors.initials: AÇ
authors.lastname: Aykan
authors.forename: Ezgi
authors.initials: E
authors.lastname: Kalaycıoğlu
authors.forename: İsmail
authors.initials: İ
authors.lastname: Bolat
authors.forename: Onur
authors.initials: O
authors.lastname: Taşar
authors.forename: Özgen
authors.initials: Ö
authors.lastname: Şafak
authors.forename: Macit
authors.initials: M
authors.lastname: Kalçık
authors.forename: Cevat
authors.initials: C
authors.lastname: Kırma
authors.forename: Murat
authors.initials: M
authors.lastname: Biteker
mesh_terms: D000367:Age Factors; D000368:Aged; D000925:Anticoagulants / Q000600:supply & distribution*; D001281:Atrial Fibrillation / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D002545:Brain Ischemia / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D014421:Turkey / Q000453:epidemiology
chemical_list: D000925:Anticoagulants