Gender-Based Clinical, Therapeutic Strategies and Prognosis Differences in Atrial Fibrillation
BACKGROUND: There are limited data on gender-based differences in atrial fibrillation (AF) treatment and prognosis. We aimed to examine gender-related differences in medical attention in an emergency department (ED) and follow-up (FU) among patients diagnosed with an AF episode and to determine whether there are gender-related differences in clinical characteristics, therapeutic strategies, and long-term adverse events in this population.
METHODS: We performed a retrospective observational study of patients who presented to a tertiary hospital ER for AF from 2010 to 2015, with a minimum FU of one year. Data on medical attention received, mortality, and other adverse outcomes were collected and analyzed.
RESULTS: Among the 2013 patients selected, 1232 (60%) were female. Women were less likely than men to be evaluated by a cardiologist during the ED visit (11.5% vs. 16.6%, p = 0.001) and were less likely to be admitted (5.9% vs. 9.5%, p < 0.05). Electrical cardioversion was performed more frequently in men, both during the first episode (3.4% vs. 1.2%, p = 0.001) and during FU (15.9% vs. 10.6%, p < 0.001), despite a lower AF recurrence rate in women (9.9% vs. 18.1%). During FU, women had more hospitalizations for heart failure (26.2% vs. 16.1%, p < 0.001).
CONCLUSIONS: In patients with AF, although there were no gender differences in mortality, there were significant differences in clinical outcomes, medical attention received, and therapeutic strategies. Women underwent fewer attempts at cardioversion, had a lower probability of being evaluated by cardiologists, and showed a higher probability of hospitalization for heart failure. Being alert to these inequities should facilitate the adoption of measures to correct them.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:10 |
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| Enthalten in: |
Journal of cardiovascular development and disease - 10(2023), 10 vom: 18. Okt. |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Quesada, Aurelio [VerfasserIn] |
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| Links: |
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| Themen: |
Atrial fibrillation |
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| Anmerkungen: |
Date Revised 03.11.2023 published: Electronic Citation Status PubMed-not-MEDLINE |
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| doi: |
10.3390/jcdd10100434 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM363799508 |
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| 100 | 1 | |a Quesada, Aurelio |e verfasserin |4 aut | |
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| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a BACKGROUND: There are limited data on gender-based differences in atrial fibrillation (AF) treatment and prognosis. We aimed to examine gender-related differences in medical attention in an emergency department (ED) and follow-up (FU) among patients diagnosed with an AF episode and to determine whether there are gender-related differences in clinical characteristics, therapeutic strategies, and long-term adverse events in this population | ||
| 520 | |a METHODS: We performed a retrospective observational study of patients who presented to a tertiary hospital ER for AF from 2010 to 2015, with a minimum FU of one year. Data on medical attention received, mortality, and other adverse outcomes were collected and analyzed | ||
| 520 | |a RESULTS: Among the 2013 patients selected, 1232 (60%) were female. Women were less likely than men to be evaluated by a cardiologist during the ED visit (11.5% vs. 16.6%, p = 0.001) and were less likely to be admitted (5.9% vs. 9.5%, p < 0.05). Electrical cardioversion was performed more frequently in men, both during the first episode (3.4% vs. 1.2%, p = 0.001) and during FU (15.9% vs. 10.6%, p < 0.001), despite a lower AF recurrence rate in women (9.9% vs. 18.1%). During FU, women had more hospitalizations for heart failure (26.2% vs. 16.1%, p < 0.001) | ||
| 520 | |a CONCLUSIONS: In patients with AF, although there were no gender differences in mortality, there were significant differences in clinical outcomes, medical attention received, and therapeutic strategies. Women underwent fewer attempts at cardioversion, had a lower probability of being evaluated by cardiologists, and showed a higher probability of hospitalization for heart failure. Being alert to these inequities should facilitate the adoption of measures to correct them | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a atrial fibrillation | |
| 650 | 4 | |a electrical cardioversion | |
| 650 | 4 | |a gender | |
| 650 | 4 | |a heart failure | |
| 650 | 4 | |a mortality | |
| 700 | 1 | |a Quesada-Ocete, Javier |e verfasserin |4 aut | |
| 700 | 1 | |a Quesada-Ocete, Blanca |e verfasserin |4 aut | |
| 700 | 1 | |a Del Moral-Ronda, Víctor |e verfasserin |4 aut | |
| 700 | 1 | |a Jiménez-Bello, Javier |e verfasserin |4 aut | |
| 700 | 1 | |a Rubini-Costa, Ricardo |e verfasserin |4 aut | |
| 700 | 1 | |a Lavie, Carl J |e verfasserin |4 aut | |
| 700 | 1 | |a Morin, Daniel P |e verfasserin |4 aut | |
| 700 | 1 | |a de la Guía-Galipienso, Fernando |e verfasserin |4 aut | |
| 700 | 1 | |a Rubini-Puig, Ricardo |e verfasserin |4 aut | |
| 700 | 1 | |a Sanchis-Gomar, Fabian |e verfasserin |4 aut | |
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