Sex and Gender Differences in Thromboprophylactic Treatment of Patients With Atrial Fibrillation After the Introduction of Non–Vitamin K Oral Anticoagulants
Section snippets
Methods
This was a cross-sectional study based on individual-level patient data from the Stockholm regional health-care data warehouse (Vårdanalysdatabasen).6 It contains encrypted, anonymized data on patient age, sex, diagnoses, procedures, hospitalizations, prescription claims, and consultations including primary, secondary, and specialist ambulatory care for all individuals in the region of Stockholm, Sweden (2.2 million inhabitants). All residents in the Stockholm region with a diagnosis of atrial
Results
A total of 23,198 men and 18,504 women were diagnosed with nonvalvular atrial fibrillation by any health-care provider in the region during 2007 to 2011 (Figure 1). This corresponds to a prevalence of 2.2% for men and 1.8% for women regardless of age in 2011. By 2015, the number of individuals with diagnosis of atrial fibrillation had increased somewhat more for men to 27,237 compared with 20,461 for women, corresponding to a prevalence of 2.5% and 1.8%, respectively. Demographic
Discussion
Between 2011 and 2015, the number of patients with atrial fibrillation in Stockholm and their use of anticoagulant treatment increased substantially, from 53% in men and 48% in women to 70% regardless of the risk score in both sexes and to 75% in those with a CHA2DS2-VASc score ≥2. The previous sex difference had disappeared, and more patients with complicating co-morbidities were treated in 2015. These changes occurred following the introduction of NOACs and the replacement of CHADS2 by the CHA
Disclosures
The authors have no conflicts of interest to disclose.
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Cited by (22)
Oral Anticoagulation Use in High-Risk Patients Is Improved by Elimination of False-Positive and Inactive Atrial Fibrillation Cases
2021, American Journal of MedicineCitation Excerpt :Improving the accuracy of atrial fibrillation and all risk-factor diagnoses has importance related to quality-improvement projects to improve anticoagulant use33,43 and for future projects using databases to predict atrial fibrillation for further screening and interventions.44-51 We noted no sex difference in appropriate anticoagulant use in patients, similar to some other studies.52,53 Loikas et al52 noted that anticoagulant use in women improved and was similar to men by 2015, compared with a lower anticoagulant use in women in 2011.
Atrial Fibrillation
2021, Sex Differences in Cardiac Diseases: Pathophysiology, Presentation, Diagnosis and ManagementAn audit & feedback intervention for improved anticoagulant use in patients with atrial fibrillation in primary care
2020, International Journal of CardiologyCitation Excerpt :This is in line with a previous Swedish study from 2017 [23]. In that study men were more often dispensed anticoagulants in 2011, but in 2015 the sex differences only remained in the oldest age group (80 years and older) [23]. Women in intervention centers were more likely than women in control centers to be dispensed anticoagulants twice after the intervention.
Sex differences in stroke and major adverse clinical events in patients with atrial fibrillation: A systematic review and meta-analysis of 993,600 patients
2018, International Journal of CardiologyCitation Excerpt :The adherence of clinicians to guideline recommendations for OAC therapy is associated with a reduction in all-cause death risk [69, 70]. These data underline once more the benefits of OAC in AF patients regardless of sex, yet a lower OAC prescription rate is constantly reported amongst female AF patients [71–73]. Interestingly, there was evidence of an increased risk of CV death for female AF patients in population cohort studies, while an increased risk for CV death in male AF patients is present in RCTs.
Atrial Fibrillation in Women: from Epidemiology to Treatment
2022, Current Cardiovascular Risk Reports
See page 1306 for disclosure information.
Funding: The study was supported by the Stockholm County Council (ALF project grant number LS 2015-0630), the Erika Lederhausen foundation, Center for Gender Medicine, Karolinska Institutet, the Swedish Association of Local Authorities and Regions (SALAR, SKL 08/2254), and by the Swedish Heart-Lung Foundation.
Location: Stockholm, Sweden.