Sex differences in stroke and major adverse clinical events in patients with atrial fibrillation: A systematic review and meta-analysis of 993,600 patients

International Journal of Cardiology
Irene MarzonaMaria Carla Roncaglioni

Abstract

Atrial fibrillation (AF) is the most commonly diagnosed arrhythmia, which is associated with an increased risk of stroke. Several studies have suggested that female AF patients could have a greater risk for stroke and thromboembolic events (TE). A systematic literature review update and meta-analysis was conducted using Pubmed. The search used the terms "atrial fibrillation", "gender", "sex", "female", "women", "stroke", "thromboembolism". Main aim of the study was to compare and male AF patients for occurrence of stroke and TE. Secondary outcomes were: major bleeding, cardiovascular (CV) death and all-cause death. Forty-four studies were included in the analysis including 993,603 patients (48.9% women). After pooling the data, there was a higher risk of stroke for women vs. male AF patients (hazard ratio [HR]: 1.24; 95% confidence intervals [CIs]: 1.14-1.36). Overall, TE risk was not different between female and male patients, despite sensitivity analysis left some uncertainties. No sex differences were found for major bleeding, CV death and all-cause death. A significant relationship between increasing age and the difference in stroke risk between female and male AF patients was found (Delta HR: 1.01; 95% CI: 1.00-1.03 for ea...Continue Reading

Citations

Jul 10, 2019·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Xiaocheng ChengDongying Zhang
Mar 19, 2020·Nutrients·Valeria Raparelli The Eva Collaborative Group
Nov 28, 2019·Cardiovascular Therapeutics·Giulio Francesco RomitiValeria Raparelli
Feb 7, 2020·Journal of Neurotrauma·Chaitanya InampudiPeter J Crack
Aug 10, 2019·Internal and Emergency Medicine·Giuseppe BorianiMarco Vitolo
Mar 31, 2020·European Journal of Clinical Pharmacology·Diana M RydbergMorten Andersen
Jun 28, 2019·Internal and Emergency Medicine·Irene MarzonaMaria Carla Roncaglioni
Dec 18, 2020·Journal of Cardiovascular Electrophysiology·Annabelle Santos VolgmanUNKNOWN American College of Cardiology Committee on Cardiovascular Disease in Women
Jan 1, 2021·European Heart Journal Supplements : Journal of the European Society of Cardiology·Deirdre A Lane, Gregory Y H Lip
Oct 6, 2020·Brain, Behavior, and Immunity·Damien LevardMarina Rubio
May 23, 2020·Journal of the American College of Cardiology·Leslie ChoUNKNOWN ACC CVD Womens Committee Members
Jul 6, 2021·Mayo Clinic Proceedings·Shubrandu S SanjoyRodrigo Bagur

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