Sex-related differences in presentation, treatment, and outcomes of Asian patients with atrial fibrillation: a report from the prospective APHRS-AF Registry
Abstract We aimed to investigate the sex-related differences in the clinical course of patients with Atrial Fibrillation (AF) enrolled in the Asia–Pacific-Heart-Rhythm-Society Registry. Logistic regression was utilized to investigate the relationship between sex and oral anticoagulant, rhythm contro...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2023-10-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-023-45345-3 |
| _version_ | 1827781182069145600 |
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| author | Tommaso Bucci Alena Shantsila Giulio Francesco Romiti Wee-Siong Teo Hyung-Wook Park Wataru Shimizu Davide Antonio Mei Hung-Fat Tse Marco Proietti Tze-Fan Chao Gregory Y. H. Lip Asia-Pacific Heart Rhythm Society Atrial Fibrillation Registry Investigators |
| author_facet | Tommaso Bucci Alena Shantsila Giulio Francesco Romiti Wee-Siong Teo Hyung-Wook Park Wataru Shimizu Davide Antonio Mei Hung-Fat Tse Marco Proietti Tze-Fan Chao Gregory Y. H. Lip Asia-Pacific Heart Rhythm Society Atrial Fibrillation Registry Investigators |
| author_sort | Tommaso Bucci |
| collection | DOAJ |
| description | Abstract We aimed to investigate the sex-related differences in the clinical course of patients with Atrial Fibrillation (AF) enrolled in the Asia–Pacific-Heart-Rhythm-Society Registry. Logistic regression was utilized to investigate the relationship between sex and oral anticoagulant, rhythm control strategies and the 1-year chance to maintain sinus rhythm. Cox-regression was utilized to assess the 1-year risk of all-cause, and cardiovascular death, thromboembolic events, acute coronary syndrome, heart failure, and major bleeding. In the whole cohort (4121 patients, 69 ± 12 years,34.3% female), females had different cardiovascular risk factors, clinical manifestations, and disease perceptions than men, with more advanced age (72 ± 11 vs 67 ± 12 years, p < 0.001) and dyslipidemia (36.7% vs 41.7%, p = 0.002). Coronary artery disease was more prevalent in males (21.1% vs 16.1%, p < 0.001) as well as the use of antiplatelet drugs. Females had a higher use of oral anticoagulant (84.9% vs 81.3%, p = 0.004) but this difference was non-significant after adjustment for confounders. On multivariable analyses, females were less often treated with rhythm control strategies (Odds Ratio [OR] 0.44,95% Confidence Interval [CI] 0.38–0.51) and were less likely to maintain sinus rhythm (OR 0.27, 95% CI 0.22–0.34) compared to males. Cox-regressions analysis showed no sex-related differences for the risk of death, cardiovascular, and bleeding. The clinical management of Asian AF patients should consider several sex-related differences. |
| first_indexed | 2024-03-11T15:15:14Z |
| format | Article |
| id | doaj.art-e7c37f51a6d841698c68645703ff350e |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-03-11T15:15:14Z |
| publishDate | 2023-10-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-e7c37f51a6d841698c68645703ff350e2023-10-29T12:23:02ZengNature PortfolioScientific Reports2045-23222023-10-0113111110.1038/s41598-023-45345-3Sex-related differences in presentation, treatment, and outcomes of Asian patients with atrial fibrillation: a report from the prospective APHRS-AF RegistryTommaso Bucci0Alena Shantsila1Giulio Francesco Romiti2Wee-Siong Teo3Hyung-Wook Park4Wataru Shimizu5Davide Antonio Mei6Hung-Fat Tse7Marco Proietti8Tze-Fan Chao9Gregory Y. H. Lip10Asia-Pacific Heart Rhythm Society Atrial Fibrillation Registry InvestigatorsLiverpool Centre of Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest HospitalLiverpool Centre of Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest HospitalLiverpool Centre of Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest HospitalDepartment of Cardiology, National Heart CentreDepartment of Cardiovascular Medicine, Chonnam National University HospitalDepartment of Cardiovascular Medicine, Nippon Medical SchoolLiverpool Centre of Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest HospitalDivision of Cardiology, Department of Medicine, School of Clinical Medicine, Queen Mary Hospital, the University of Hong KongDepartment of Clinical Sciences and Community Health, University of MilanInstitute of Clinical Medicine, and Cardiovascular Research Center, National Yang Ming Chiao Tung UniversityLiverpool Centre of Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest HospitalAbstract We aimed to investigate the sex-related differences in the clinical course of patients with Atrial Fibrillation (AF) enrolled in the Asia–Pacific-Heart-Rhythm-Society Registry. Logistic regression was utilized to investigate the relationship between sex and oral anticoagulant, rhythm control strategies and the 1-year chance to maintain sinus rhythm. Cox-regression was utilized to assess the 1-year risk of all-cause, and cardiovascular death, thromboembolic events, acute coronary syndrome, heart failure, and major bleeding. In the whole cohort (4121 patients, 69 ± 12 years,34.3% female), females had different cardiovascular risk factors, clinical manifestations, and disease perceptions than men, with more advanced age (72 ± 11 vs 67 ± 12 years, p < 0.001) and dyslipidemia (36.7% vs 41.7%, p = 0.002). Coronary artery disease was more prevalent in males (21.1% vs 16.1%, p < 0.001) as well as the use of antiplatelet drugs. Females had a higher use of oral anticoagulant (84.9% vs 81.3%, p = 0.004) but this difference was non-significant after adjustment for confounders. On multivariable analyses, females were less often treated with rhythm control strategies (Odds Ratio [OR] 0.44,95% Confidence Interval [CI] 0.38–0.51) and were less likely to maintain sinus rhythm (OR 0.27, 95% CI 0.22–0.34) compared to males. Cox-regressions analysis showed no sex-related differences for the risk of death, cardiovascular, and bleeding. The clinical management of Asian AF patients should consider several sex-related differences.https://doi.org/10.1038/s41598-023-45345-3 |
| spellingShingle | Tommaso Bucci Alena Shantsila Giulio Francesco Romiti Wee-Siong Teo Hyung-Wook Park Wataru Shimizu Davide Antonio Mei Hung-Fat Tse Marco Proietti Tze-Fan Chao Gregory Y. H. Lip Asia-Pacific Heart Rhythm Society Atrial Fibrillation Registry Investigators Sex-related differences in presentation, treatment, and outcomes of Asian patients with atrial fibrillation: a report from the prospective APHRS-AF Registry Scientific Reports |
| title | Sex-related differences in presentation, treatment, and outcomes of Asian patients with atrial fibrillation: a report from the prospective APHRS-AF Registry |
| title_full | Sex-related differences in presentation, treatment, and outcomes of Asian patients with atrial fibrillation: a report from the prospective APHRS-AF Registry |
| title_fullStr | Sex-related differences in presentation, treatment, and outcomes of Asian patients with atrial fibrillation: a report from the prospective APHRS-AF Registry |
| title_full_unstemmed | Sex-related differences in presentation, treatment, and outcomes of Asian patients with atrial fibrillation: a report from the prospective APHRS-AF Registry |
| title_short | Sex-related differences in presentation, treatment, and outcomes of Asian patients with atrial fibrillation: a report from the prospective APHRS-AF Registry |
| title_sort | sex related differences in presentation treatment and outcomes of asian patients with atrial fibrillation a report from the prospective aphrs af registry |
| url | https://doi.org/10.1038/s41598-023-45345-3 |
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