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Gender differences in the risk of ischemic stroke and peripheral embolism in atrial fibrillation: the AnTicoagulation and Risk factors In Atrial fibrillation (ATRIA) study.
| Content Provider | Semantic Scholar |
|---|---|
| Author | Chang, Yuchiao Henault, Lori |
| Copyright Year | 2005 |
| Abstract | BACKGROUND Previous studies provide conflicting results about whether women are at higher risk than men for thromboembolism in the setting of atrial fibrillation (AF). We examined data from a large contemporary cohort of AF patients to address this question. METHODS AND RESULTS We prospectively studied 13,559 adults with AF and recorded data on patients' clinical characteristics and the occurrence of incident hospitalizations for ischemic stroke, peripheral embolism, and major hemorrhagic events through searching validated computerized databases and medical record review. We compared event rates by patient sex using multivariable log-linear regression, adjusting for clinical risk factors for stroke, and stratifying by warfarin use. We identified 394 ischemic stroke and peripheral embolic events during 15,494 person-years of follow-up off warfarin. After multivariable analysis, women had higher annual rates of thromboembolism off warfarin than did men (3.5% versus 1.8%; adjusted rate ratio [RR], 1.6; 95% CI, 1.3 to 1.9). There was no significant difference by sex in 30-day mortality after thromboembolism (23% for both). Warfarin use was associated with significantly lower adjusted thromboembolism rates for both women and men (RR, 0.4; 95% CI, 0.3 to 0.5; and RR, 0.6; 95% CI, 0.5 to 0.8, respectively), with similar annual rates of major hemorrhage (1.0% and 1.1%, respectively). CONCLUSIONS Women are at higher risk than men for AF-related thromboembolism off warfarin. Warfarin therapy appears be as effective in women, if not more so, than in men, with similar rates of major hemorrhage. Female sex is an independent risk factor for thromboembolism and should influence the decision to use anticoagulant therapy in persons with AF. |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | http://circ.ahajournals.org/content/circulationaha/112/12/1687.full.pdf?download=true |
| Alternate Webpage(s) | http://circ.ahajournals.org/content/circulationaha/112/12/1687.full.pdf |
| PubMed reference number | 16157766v1 |
| Volume Number | 112 |
| Issue Number | 12 |
| Journal | Circulation |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | Anticoagulants Atrial Fibrillation Cerebral Infarction Cerebrovascular accident Cooley's anemia Embolism Gastrointestinal Hemorrhage Heart Atrium Hospitalization Medical Records Nevus sebaceous Patients Peripheral Vascular Diseases Sex Factors Thromboembolism Ventricular Fibrillation Warfarin |
| Content Type | Text |
| Resource Type | Article |
