TY - JOUR
T1 - Gender-related differences in management of nonvalvular atrial fibrillation in an asian population
AU - Lee, Jung Myung
AU - Kim, Tae Hoon
AU - Cha, Myung Jin
AU - Park, Junbeom
AU - Park, Jin Kyu
AU - Kang, Ki Woon
AU - Shim, Jaemin
AU - Uhm, Jae Sun
AU - Kim, Jun
AU - Park, Hyung Wook
AU - Lee, Young Soo
AU - Choi, Eue Keun
AU - Kim, Chang Soo
AU - Joung, Boyoung
AU - Kim, Jin Bae
N1 - Funding Information:
This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF), which is funded by the Ministry of Science, ICT & Future Planning (NRF-2012R1A2A2A02045367, 2010-0021993). This work was also supported by grants from the Korean Healthcare Technology R & D Project, which is funded by the Ministry of Health & Welfare (HI12C1552, HI16C0058, and HI15C1200).
Publisher Copyright:
© 2018 The Korean Society of Cardiology.
Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2018/6
Y1 - 2018/6
N2 - Background and Objectives: Gender-related differences in health care utilization for atrial fbrillation (AF) are increasingly recognized. However, large cohort data for examining gender-related differences in AF are lacking in Asian populations. Methods: The Registry for Comparison Study of Drugs for Symptom Control and Complication Prevention of AF (CODE-AF Registry) is a prospective observational cohort-study that enrolled participants at 10 tertiary hospitals in South Korea. Baseline characteristics retrieved from the CODE-AF Registry were analyzed. Results: A total of 6,274 patients were recruited (mean age 67±11 years, mean CHA2DS2-VASc score 2.7±1.7, 63% male, 65% paroxysmal AF) from June 2016 to April 2017. Women underwent less electric cardioversion (12.3% vs. 19.6%, p<0.001), less radiofrequency ablation (12.4% vs. 17.9%, p<0.001), and less antiarrhythmic drug therapy (44.7% vs. 49.5%, p<0.001), despite having more severe symptoms (symptom class III or IV, 45.8% vs. 37.5%, p<0.001). Among patients with a CHA2DS2-VA score of 2 or more, a slightly higher proportion of women were taking oral anticoagulants than men (85.7% vs. 81.9%, p=0.002), and nonvitamin K antagonist oral anticoagulant (NOAC) use was more prevalent in women than men (70.4% vs. 62.3%, p<0.001). Insufcient NOAC dosing was very common, more so in women than men (61.5% vs. 56.3%, p<0.001). Conclusions: Female patients with AF were treated more conservatively and rhythm control strategies were used less frequently than in males, even though the female patients with AF had more severe symptoms. While insufcient NOAC dosing was common in both sex, it was signifcantly more frequent in women.
AB - Background and Objectives: Gender-related differences in health care utilization for atrial fbrillation (AF) are increasingly recognized. However, large cohort data for examining gender-related differences in AF are lacking in Asian populations. Methods: The Registry for Comparison Study of Drugs for Symptom Control and Complication Prevention of AF (CODE-AF Registry) is a prospective observational cohort-study that enrolled participants at 10 tertiary hospitals in South Korea. Baseline characteristics retrieved from the CODE-AF Registry were analyzed. Results: A total of 6,274 patients were recruited (mean age 67±11 years, mean CHA2DS2-VASc score 2.7±1.7, 63% male, 65% paroxysmal AF) from June 2016 to April 2017. Women underwent less electric cardioversion (12.3% vs. 19.6%, p<0.001), less radiofrequency ablation (12.4% vs. 17.9%, p<0.001), and less antiarrhythmic drug therapy (44.7% vs. 49.5%, p<0.001), despite having more severe symptoms (symptom class III or IV, 45.8% vs. 37.5%, p<0.001). Among patients with a CHA2DS2-VA score of 2 or more, a slightly higher proportion of women were taking oral anticoagulants than men (85.7% vs. 81.9%, p=0.002), and nonvitamin K antagonist oral anticoagulant (NOAC) use was more prevalent in women than men (70.4% vs. 62.3%, p<0.001). Insufcient NOAC dosing was very common, more so in women than men (61.5% vs. 56.3%, p<0.001). Conclusions: Female patients with AF were treated more conservatively and rhythm control strategies were used less frequently than in males, even though the female patients with AF had more severe symptoms. While insufcient NOAC dosing was common in both sex, it was signifcantly more frequent in women.
KW - Anticoagulants
KW - Asian ceancestry group
KW - Atrial fbrillation
KW - Registries
KW - Sex characteristics
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U2 - 10.4070/kcj.2017.0389
DO - 10.4070/kcj.2017.0389
M3 - Article
AN - SCOPUS:85048142182
VL - 48
SP - 519
EP - 528
JO - Korean Circulation Journal
JF - Korean Circulation Journal
SN - 1738-5520
IS - 6
ER -