Arrhythmias & electrophysiology
Atrial fibrillation and female sex: use of oral anticoagulants in a large European cohort and residual risk of thromboembolism and stroke
Main finding · OAC prescriptionResult — go to the resultOdds ratio 0.79 95% CI 0.69–0.90Authors' conclusion
In AF patients treated with OAC, the increased residual risk of STE associated with female sex was non-significant after adjusting for confounders and the competing risk of death. Both scores had similar predictive performance but CHA2DS2-VA showed worse reclassification compared with CHA2DS2-VASc.
Study context
- Population
- Patients with atrial fibrillation (AF) with CHA2DS2-VA score ≥1patients with CHA2DS2-VA ≥1, 41.8% women, mean age 70.1 (SD 10.0) years
- Participants
- 10,080 patients
- Exposure
- Women vs men
- Outcome
- OAC prescription
Main finding
As reported in the abstract
Odds ratio
0.79
95% CI 0.69–0.90
Women vs men
OR 0.79 (95% CI 0.69–0.90)
Observational data: associations, not effects.
Further findings
IR, per 100 person-years
| Outcome | Women | Men | sHR (95% CI) | P value | |
|---|---|---|---|---|---|
| STE rates in OAC-treated patientsAdjusted for confounders and the competing risk of death | 1.33 | 0.94 | 1.24 (0.89–1.74) | P = 0.210 | |
| 0.512Subdistribution hazard ratio (log scale) |
| Outcome | Net reclassification index (95% CI) | P value |
|---|---|---|
| Predictive performance of CHA2DS2-VA vs. CHA2DS2-VAScCHA2DS2-VA vs CHA2DS2-VASc · 0.603 vs. 0.605 | P = 0.665 | |
| Predictive performance of CHA2DS2-VA vs. CHA2DS2-VAScCHA2DS2-VA vs CHA2DS2-VASc · worse (i.e. negative) reclassification with CHA2DS2-VA | −0.088 (−0.164 to −0.001) |
- Predictive performance of CHA2DS2-VA vs. CHA2DS2-VASc: CHA2DS2-VA AUC 0.603
- Predictive performance of CHA2DS2-VA vs. CHA2DS2-VASc: CHA2DS2-VASc AUC 0.605
Predictive performance of CHA2DS2-VA vs. CHA2DS2-VASc
- No significant differences in discrimination or net benefit
Original publication
Atrial fibrillation and female sex: use of oral anticoagulants in a large European cohort and residual risk of thromboembolism and stroke. Eur Heart J Qual Care Clin Outcomes. Published 4 August 2025. doi:10.
Summarised from the published abstract; every number is checked against it