Sex-Based Differences in Outcomes of Oral Anticoagulation in Patients With Atrial Fibrillation

Journal of the American College of Cardiology
Sharon W Y LawEsther W Chan

Abstract

Women with atrial fibrillation are at a higher risk of stroke, despite treatment with warfarin. It is unclear if women treated with direct oral anticoagulants (DOACs) have better clinical outcomes, especially when considering the quality of anticoagulation control of warfarin. This study compared the effectiveness and safety outcomes of DOACs versus warfarin in men and women with stratifications for anticoagulation control. Patients newly diagnosed with atrial fibrillation and prescribed oral anticoagulants during 2010 to 2015 were identified using the Hong Kong clinical database. Propensity score matching was performed in men and women separately. Further analysis was conducted to stratify warfarin users according to their anticoagulation control. Cox regression was used to compare the risk of ischemic stroke or systemic embolism, intracranial hemorrhage (ICH), gastrointestinal bleeding, and all-cause mortality in the specific sex. There were 4,972 men and 4,834 women successfully matched in our cohort. Compared with warfarin, DOAC use was associated with a lower risk of ICH (hazard ratio [HR]: 0.16; 95% confidence interval [CI]: 0.06 to 0.40) and all-cause mortality (HR: 0.55; 95% CI: 0.39 to 0.77) in women but not in men. Th...Continue Reading

Citations

Sep 22, 2018·Journal of Cardiovascular Medicine·Susanna SciomerGiuseppe Mercuro
Apr 9, 2020·Journal of Cardiovascular Pharmacology and Therapeutics·Arnaud PagèsBrigitte Sallerin
May 30, 2020·The American Journal of Gastroenterology·Jiaxi ZhaoEsther W Chan
Jul 21, 2020·Cardiovascular Therapeutics·Mariacarla GallùAnnalisa Noce
Oct 29, 2020·Clinical Pharmacology and Therapeutics·Phatcharin MitsuntisukGregory Y H Lip
Nov 23, 2020·European Journal of Clinical Investigation·Woldesellassie M BezabheGregory M Peterson
Apr 19, 2020·European Journal of Internal Medicine·Inmaculada Roldán RabadánUNKNOWN FANTASIIA Study Investigators
Dec 25, 2019·World Neurosurgery·Farshad NassiriFarhad Pirouzmand
Jun 15, 2021·Frontiers in Pharmacology·Roberta RobertiRita Citraro
Jan 8, 2022·Journal of Cardiovascular Pharmacology and Therapeutics·Eliana FerroniVittorio Pengo

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