title: Gender differences in clinical presentation and 1-year outcomes in atrial fibrillation.
abstract: Our objective was to examine gender differences in clinical presentation, management and prognosis of atrial fibrillation (AF) in a contemporary cohort.
  
  
  
  In 6412 patients, 39.7% women, of the PREvention oF thromboembolic events - European Registry in Atrial Fibrillation, we examined gender differences in symptoms, risk factors, therapies and 1-year incidence of adverse outcomes.
  
  
  
  Men with AF were on average younger than women (mean±SD: 70.1±10.7 vs 74.1±9.7 years, p<0.0001). Women more frequently had at least one AF-related symptom at least occasionally compared with men (95.4% in women, 89.8% in men, p<0.0001). Prescription of oral anticoagulation was similar, with an increase of non-vitamin K antagonist oral anticoagulants from 5.9% to 12.6% in women and from 6.2% to 12.6% in men, p<0.0001 for both.Men were more frequently treated with electrical cardioversion and ablation (20.6% and 6.3%, respectively) than women (14.9% and 3.3%, respectively), p<0.0001. Women had 65% (OR: 0.35; 95% CI (0.22 to 0.56)) lower age-adjusted and country-adjusted odds of coronary revascularisation, 40% (OR: 0.60; (0.38 to 0.93)) lower odds of acute coronary syndrome and 20% (OR: 0.80; (0.68 to 0.96)) lower odds of heart failure at 1 year. There were no statistically significant gender differences in 1-year stroke/transient ischaemic attack/arterial thromboembolism and major bleeding events.
  
  
  
  In a 'real-world' European AF registry, women were more symptomatic but less likely to receive invasive rhythm control therapy such as electrical cardioversion or ablation. Further study is needed to confirm that these differences do not disadvantage women with AF.
authors.affiliation: Department of Cardiology, University Heart Center Hamburg-Eppendorf, German Center for Cardiovascular Research (DZHK) partner site Hamburg/Kiel/Lübeck, Hamburg, Germany.
authors.forename: Renate B
authors.initials: RB
authors.lastname: Schnabel
authors.affiliation: Medical Facility Pilsen of Charles University, Pilsen, Czech Republic.
authors.forename: Ladislav
authors.initials: L
authors.lastname: Pecen
authors.affiliation: Department of Cardiology, University Heart Center Hamburg-Eppendorf, German Center for Cardiovascular Research (DZHK) partner site Hamburg/Kiel/Lübeck, Hamburg, Germany.
authors.forename: Francisco M
authors.initials: FM
authors.lastname: Ojeda
authors.affiliation: Daiichi Sankyo Europe GmbH, Munich, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Lucerna
authors.affiliation: Department of Cardiology, University Heart Center Hamburg-Eppendorf, German Center for Cardiovascular Research (DZHK) partner site Hamburg/Kiel/Lübeck, Hamburg, Germany.
authors.forename: Nargiz
authors.initials: N
authors.lastname: Rzayeva
authors.affiliation: Department of Cardiology, University Heart Center Hamburg-Eppendorf, German Center for Cardiovascular Research (DZHK) partner site Hamburg/Kiel/Lübeck, Hamburg, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Blankenberg
authors.affiliation: Department of Cardiology, Angiology, Nephrology and Conservative Intensive Care Medicine, Vivantes Klinikum Neukolln, Berlin, Germany.
authors.forename: Harald
authors.initials: H
authors.lastname: Darius
authors.affiliation: School of Clinical & Experimental Medicine, University of Birmingham, Birmingham, UK.
authors.forename: Dipak
authors.initials: D
authors.lastname: Kotecha
authors.affiliation: G. d'Annunzio University of Chieti-Pescara, Chieti, Italy.|Fondazione G. Monasterio, Pisa, Italy.
authors.forename: Raffaele De
authors.initials: R
authors.lastname: Caterina
authors.affiliation: Institute of Cardiovascular Sciences, University of Birmingham and SWBH and UHB NHS Trust, Birmingham, UK.|AFNET, Münster, Germany.
authors.forename: Paulus
authors.initials: P
authors.lastname: Kirchhof
mesh_terms: D000367:Age Factors; D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology; D005060:Europe / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D011379:Prognosis; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D012737:Sex Factors; D015996:Survival Rate / Q000639:trends; D013923:Thromboembolism / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D013997:Time Factors
chemical_list: D000925:Anticoagulants
keywords: Atrial fibrillation; European registry; gender differences