Study Objective: To examine sex differences in oral anticoagulation management and outcomes among patients with incident nonvalvular atrial fibrillation presenting to the emergency department (ED).
Methods: We identified patients older than 20 years presenting to the ED with incident nonvalvular atrial fibrillation between April 1, 2012, and March 30, 2019, using linked administrative databases in Alberta, Canada. We assessed the use of and adherence to oral anticoagulants at 1 year using the proportion of days covered for direct oral anticoagulants and time in therapeutic range for warfarin. Outcomes included stroke, heart failure, and all-cause mortality at 1 year.
Results: Of the 28,886 patients with nonvalvular atrial fibrillation presenting to ED, 44% were females. After adjustment, the rate of oral anticoagulant use was 5% lower in females with a guideline indication than that in males (adjusted hazard ratio 0.95, 95% confidence interval [CI] 0.91 to 0.99) discharged home, and there was no difference among admitted patients (adjusted hazard ratio 1.00, 95% CI 0.96 to 1.05). Females had high adherence to direct oral anticoagulants (≥80% proportion of days covered) compared to males (discharged: 77.7% versus 74.0%; admitted: 80.0% versus 76.7%; adjusted odds ratio for females: 1.15, 95% CI 1.02 to 1.29). More than half of the females and males had poor warfarin control (time in therapeutic range <65%) regardless of discharge status. In multivariable analyses, there was no sex difference in outcomes except a 1.48-fold (95% CI 1.14 to 1.92) higher risk of stroke in females.
Conclusion: Females with incident nonvalvular atrial fibrillation discharged from the ED are less likely to receive oral anticoagulants than males. When oral anticoagulant treatment is initiated, females have high adherence to direct oral anticoagulants, and both the sexes have poor warfarin control. At 1 year, females were at a significantly higher risk of developing stroke.
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http://dx.doi.org/10.1016/j.annemergmed.2022.03.010 | DOI Listing |
J Cardiothorac Surg
January 2025
Department of Cardiology, Fujian Medical University Union Hospital, Fujian Heart Medical Center, Fujian Institute of Coronary Heart Disease, Fujian Clinical Medical Research Center for Heart and Macrovascular Disease, Fuzhou, 350001, China.
Objective: The objective of this study is to assess the predictive utility of perioperative P-wave parameters in patients with paroxysmal atrial fibrillation (PAF) undergoing catheter ablation, and to develop a predictive model using these parameters.
Methods: A total of 213 patients with PAF undergoing catheter ablation were retrospectively analyzed. P-wave parameters were measured within 3 days preoperatively and on the day postoperatively to determine their predictive significance for postoperative PAF recurrence.
BMC Cardiovasc Disord
January 2025
Department of Cardiology, Affiliated Hospital of Hangzhou Normal University, Zhejiang Key Laboratory of Medical Epigenetics, School of Basic Medical Sciences,Hangzhou Institute of Cardiovascular Diseases, Engineering Research Center of Mobile Health Management System & Ministry of Education, Hangzhou Normal University, Hangzhou, 310015, China.
Objective: The effect of sodium intake on atrial fibrillation (AF)/atrial flutter (AFL), with respect to sex and age, has yet to be elucidated. This study aims to compare long-term trends in AF/AFL death and disability due to high sodium intake in China from 1990 to 2019.
Methods: We utilized data from the Global Burden of Disease study to assess the mortality and disability burden of AF/AFL attributable to high sodium intake (> 5 g/d) in China from 1990 to 2019.
Lipids Health Dis
January 2025
Department of Cardiology, West China Hospital, Sichuan University West China School of Medicine, 37 Guoxue Road, Chengdu, Sichuan, 610041, China.
Background: Atrial fibrillation (AF) is the most prevalent arrhythmia encountered in clinical practice. Triglyceride glucose index (Tyg), a convenient evaluation variable for insulin resistance, has shown associations with adverse cardiovascular outcomes. However, studies on the Tyg index's predictive value for adverse prognosis in patients with AF without diabetes are lacking.
View Article and Find Full Text PDFBMC Prim Care
January 2025
Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.
Aims: To study differences in cardiovascular prevention and hypertension management in primary care in men and women, with comparisons between public and privately operated primary health care (PHC).
Methods: We used register data from Region Stockholm on collected prescribed medication and registered diagnoses, to identify patients aged 30 years and above with hypertension. Age-adjusted logistic regression was used to calculate odds ratios (ORs) with 99% confidence intervals (99% CIs) using public PHC centers as referents.
J Interv Card Electrophysiol
January 2025
Division of Cardiology, Northwestern University, Chicago, IL, USA.
Atrial arrhythmias, including atrial fibrillation (AF), are a major contributor to cardiovascular morbidity and mortality. Early detection and effective management are critical to mitigating adverse outcomes such as stroke, heart failure, and overall mortality. Wearable devices have emerged as promising tools for monitoring, detecting, and managing atrial arrhythmias near-continuously.
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