Arrhythmias & electrophysiology
Stroke risks in women vs men in Asian patients with atrial fibrillation: A temporal trend analysis and a comparison of the CHA2DS2-VASc and CHA2DS2-VA stroke risk stratification scores
Main finding · Ischemic stroke, women vs men, across calendar yearsResult — go to the resultIncidence rate ratio 1.13-1.26Authors' conclusion
Women with AF have a higher stroke risk than men only in high CHA2DS2-VA score categories, suggesting female sex is more likely to be a risk modifier of stroke in AF.
Study context
- Population
- Newly diagnosed, non-anticoagulated patients with atrial fibrillation (AF), Taiwan National Health Database, 2000–202144% women
- Participants
- 495,569 participants
- Exposure
- Women vs men; CHA2DS2-VASc vs CHA2DS2-VA
- Outcome
- Ischemic stroke risk in women vs men over time; performance of CHA2DS2-VASc vs CHA2DS2-VA (net reclassification index, integrated discrimination improvement, C-statistics)
Methodological detailsnationwide database, temporal trend analysis
- Nationwide database
- Temporal trend analysis
Main finding
As reported in the abstract
Ischemic stroke, women vs men, across calendar years
Incidence rate ratio
1.13-1.26
all P < .05
Observational data: associations, not effects.
Further findings
| Outcome | IRR | P value |
|---|---|---|
| Stroke risk, women vs men, by CHA2DS2-VA score (subgroups)Women vs Men · score 0 | 0.81 | P < 0.001 |
| Stroke risk, women vs men, by CHA2DS2-VA score (subgroups)Women vs Men · score 1 | 0.88 | P < 0.001 |
| Stroke risk, women vs men, by CHA2DS2-VA score (subgroups)Women vs Men · scores 2-8 | 1.04-1.11 | all P < .05 |
Score performance: CHA2DS2-VASc vs CHA2DS2-VA
- C-statistics slightly higher for CHA2DS2-VASc, 2000 to 2013
- P < 0.05
- C-statistics not significantly different after 2014
- P > 0.05
- CHA2DS2-VASc significantly outperformed CHA2DS2-VA in net reclassification index, 2000 to 2021
- CHA2DS2-VASc significantly outperformed CHA2DS2-VA in integrated discrimination improvement, 2000 to 2015
Original publication
Stroke risks in women vs men in Asian patients with atrial fibrillation: A temporal trend analysis and a comparison of the CHA2DS2-VASc and CHA2DS2-VA stroke risk stratification scores. Heart Rhythm. Published 3 June 2025. doi:10.
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