Arrhythmias & electrophysiology
Sex-Specific Temporal Trends in the Incidence of Heart Failure Among Patients With Atrial Fibrillation: A Population-Based Study
Authors' conclusion
Despite an overall decrease in the risk of HF among AF patients over two decades of follow-up, women retained elevated residual adjusted HF risk after full adjustment for time-varying comorbidities.
Study context
- Population
- Patients newly diagnosed with atrial fibrillation (AF) in Hong Kong between 1997 and 2021individuals with newly diagnosed AF (median age: 76.6 years, IQR: 60.4–92.8, 48.6% female)
- Participants
- 130,132 patients
- Exposure
- Sex differences in the temporal trend of incident heart failure (HF) among patients with atrial fibrillation (AF)
- Outcome
- Annual IR (per 1000 person-years) of HF
- Follow-up
- Between 1997 and 2021
Methodological detailsPoisson regression analysis, Multivariate adjusted Fine-Gray regression models, all-cause mortality as a competing event
- Poisson regression analysis
- Multivariate adjusted Fine-Gray regression models
- All-cause mortality as a competing event
Main finding
As reported in the abstract
Women
69.6 to 16.7
annual incidence rate (IR) · per 1000 person-years
Men
44.5 to 13.7
annual IR · per 1000 person-years
Observational data: associations, not effects.
Further findings
IR, per 1000 person-years
| Outcome | Women | Men | Incidence rate ratio (95% CI) | |
|---|---|---|---|---|
| HF incidence, entire follow-up periodHigher risk of HF in women | 25.3 | 19.3 | 1.34 (1.31–1.37) | |
| 0.512Incidence rate ratio (log scale) |
Baseline characteristics by sex
- Women were older at the time of diagnosis of AF, had higher baseline CHA2DS2-VASc scores, and were more likely to be prescribed reduced doses of direct oral anticoagulants
Original publication
Sex-Specific Temporal Trends in the Incidence of Heart Failure Among Patients With Atrial Fibrillation: A Population-Based Study. JACC Clin Electrophysiol. Published 18 September 2026. doi:10. 1016/ j. jacep. 2026. 08. 014
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