Arrhythmias & electrophysiologyCohort study
Gender and contemporary risk of adverse events in atrial fibrillation
- Population cohort study
- electronic healthcare records
- UK primary care
Authors' conclusion
Removal of gender from clinical risk scoring could simplify the approach to which patients with AF should be offered oral anticoagulation.
Study context
- Population
- Patients aged 40–75 years with atrial fibrillation (AF), no prior stroke and no OAC prescription, UK primary care 2005–2020431,086 patient-years follow-up
- Participants
- 78,852 patients
- Exposure
- Women vs men
- Womenn = 28,590
- Menn = 50,262reference
Main finding
As reported in the abstract
Women vs MenHazard ratio (95% CI)P value
adjusted
0.89(0.87–0.92)
P < 0.001after censoring for OAC
0.87(0.83–0.91)
P < 0.001Observational data: associations, not effects.
Secondary outcomes
| Outcome | Values | Estimate | P value | |
|---|---|---|---|---|
| All-cause mortality | HR 0.86 (95% CI 0.83–0.89) | P < 0.001 | ||
| Ischaemic stroke or arterial thromboembolism | adjusted HR 1.00 (95% CI 0.94–1.07) | P = 0.87 | ||
| Any stroke or any thromboembolism | adjusted HR 1.02 (95% CI 0.96–1.07) | P = 0.58 | ||
| Incident vascular dementia | adjusted HR 1.13 (95% CI 0.97–1.32) | P = 0.11 | ||
| 0.512Ratio (log scale) |
| Outcome | Values | Estimate | P value |
|---|---|---|---|
| Prediction of primary outcome: CHA2DS2-VA vs CHA2DS2-VASc | CHA2DS2-VA ROC curve area 0.651 · CHA2DS2-VASc ROC curve area 0.639 |
- Prediction of primary outcome: CHA2DS2-VA vs CHA2DS2-VASc — CHA2DS2-VA superior
- P < .001
- Prediction of primary outcome: CHA2DS2-VA vs CHA2DS2-VASc: no interaction with gender (P = .45)
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Gender and contemporary risk of adverse events in atrial fibrillation. Eur Heart J. Published 1 September 2024. doi:10.1093/eurheartj/ehae539
Summarised from the published abstract; every number is checked against it