Arrhythmias & electrophysiologyCohort study
Trends in stroke risk among female and male patients with atrial fibrillation: A 20-year population-based cohort study
- population-based retrospective cohort study
Authors' conclusion
While the point estimates suggest a gradual attenuation in the excess stroke risk among females over time, no statistically significant temporal trend was observed.
Study context
- Population
- Nonanticoagulated patients with newly diagnosed nonvalvular atrial fibrillation (AF) between 2004 and 2023, database of the largest health care provider in Israel57,951 (51.5%) females
- Participants
- 112,478 patients
- Exposure
- the 1-year cumulative incidence function of female patients with that of male patients
- femalesn = 57,951
Main finding
As reported in the abstract
Age
Observational data: associations, not effects.
Further findings
| Outcome | relative risk (95% CI) | |
|---|---|---|
| Stroke (ischemic stroke or systemic embolism), CHA2DS2-VA score-adjusted, by period · 1-year — females vs males · 2004-2007 · pseudo-value approach | 1.16 (0.85–1.57) | |
| Stroke (ischemic stroke or systemic embolism), CHA2DS2-VA score-adjusted, by period · 1-year — females vs males · 2008-2011 · pseudo-value approach | 1.20 (0.92–1.57) | |
| Stroke (ischemic stroke or systemic embolism), CHA2DS2-VA score-adjusted, by period · 1-year — females vs males · 2012-2015 · pseudo-value approach | 1.29 (1.01–1.64) | |
| Stroke (ischemic stroke or systemic embolism), CHA2DS2-VA score-adjusted, by period · 1-year — females vs males · 2016-2019 · pseudo-value approach | 1.06 (0.85–1.32) | |
| Stroke (ischemic stroke or systemic embolism), CHA2DS2-VA score-adjusted, by period · 1-year — females vs males · 2020-2023 · pseudo-value approach | 0.99 (0.79–1.23) | |
| 0.512Relative risk (log scale) |
1-year crude cumulative incidence of stroke
- Females consistently had a higher 1-year crude cumulative incidence of stroke, with both sexes showing an increase over time followed by a recent decline, peaking earlier in females
Original publication
Trends in stroke risk among female and male patients with atrial fibrillation: A 20-year population-based cohort study. Heart Rhythm. Published 30 June 2026. doi:10.1016/j.hrthm.2026.06.028
Summarised from the published abstract; every number is checked against it