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| Content Provider | World Health Organization (WHO)-Global Index Medicus |
|---|---|
| Author | Rosenqvist, Mårten Friberg, Leif Benson, Lina Lip, Gregory Y. H. |
| Spatial Coverage | Sweden |
| Description | Author Affiliation: Friberg L ( Karolinska Institute, Danderyd Hospital, Stockholm, Sweden. leif.friberg@ki.se); |
| Abstract | Objective To determine whether women with atrial fibrillation have a higher risk of stroke than men. Design Nationwide retrospective cohort study. Setting Patients with a diagnosis of atrial fibrillation in the Swedish hospital discharge register between 1 July 2005 and 31 December 2008. Information about drug treatment taken from the Swedish drug register. Participants 100 802 patients with atrial fibrillation at any Swedish hospital or hospital affiliated outpatient clinic with a total follow-up of 139 504 years at risk (median 1.2 years). We excluded patients with warfarin at baseline, mitral stenosis, previous valvular surgery, or who died within 14 days from baseline. Main outcome measure Incidence of ischaemic stroke. Results Ischaemic strokes were more common in women than in men (6.2% v 4.2% per year, P<0.0001). The univariable hazard ratio for women compared with men was 1.47 (95% confidence 1.40 to 1.54), indicating a 47% higher incidence of ischaemic stroke in women than in men. Stratification according to the $CHADS_{2}$ scheme showed increased stroke rates for women in all strata. After multivariable adjustment for 35 cofactors for stroke, an increased risk of stroke in women remained (1.18, 1.12 to 1.24). Among patients with “lone atrial fibrillation” (age <65 years and no vascular disease), the annual stroke rate tended to be higher in women than in men, although this difference was not significant (0.7% v 0.5%, P=0.09). When low risk patients with $CHADS_{2}$ scores of 0-1 were stratified according to their $CHA_{2}DS_{2}-VASc$ scores, women did not have higher stroke incidence than men at $CHA_{2}DS_{2}-VASc$ scores of 2 or less. Conclusion Women with atrial fibrillation have a moderately increased risk of stroke compared with men, and thus, female sex should be considered when making decisions about anticoagulation treatment. However, women younger than 65 years and without other risk factors have a low risk for stroke, and do not need anticoagulant treatment. |
| ISSN | 09598138 |
| e-ISSN | 17561833 |
| Journal | BMJ (British Medical Journal) |
| Volume Number | 344 |
| Language | English |
| Publisher | British Medical Journal Publishing Group |
| Publisher Date | 2012-06-01 |
| Publisher Place | Great Britain (UK) |
| Access Restriction | Open |
| Subject Keyword | Atrial Fibrillation Epidemiology Stroke Complications Retrospective Studies Risk Factors Sex Factors Etiology Sweden Research Support, Non-U.S. Gov't Medicine |
| Content Type | Text |
| Resource Type | Article |
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