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Stroke risk in women with atrial fibrillation.
- Source :
- European Heart Journal; 1/7/2024, Vol. 45 Issue 2, p104-113, 10p
- Publication Year :
- 2024
-
Abstract
- Background and aims Female sex is associated with higher rates of stroke in atrial fibrillation (AF) after adjustment for other CHA<subscript>2</subscript>DS<subscript>2</subscript>-VASc factors. This study aimed to describe sex differences in age and cardiovascular care to examine their relationship with stroke hazard in AF. Methods Population-based cohort study using administrative datasets of people aged ≥66 years diagnosed with AF in Ontario between 2007 and 2019. Cause-specific hazard regression was used to estimate the adjusted hazard ratio (HR) for stroke associated with female sex over a 2-year follow-up. Model 1 included CHA<subscript>2</subscript>DS<subscript>2</subscript>-VASc factors, with age modelled as 66–74 vs. ≥ 75 years. Model 2 treated age as a continuous variable and included an age–sex interaction term. Model 3 further accounted for multimorbidity and markers of cardiovascular care. Results The cohort consisted of 354 254 individuals with AF (median age 78 years, 49.2% female). Females were more likely to be diagnosed in emergency departments and less likely to receive cardiologist assessments, statins, or LDL-C testing, with higher LDL-C levels among females than males. In Model 1, the adjusted HR for stroke associated with female sex was 1.27 (95% confidence interval 1.21–1.32). Model 2 revealed a significant age–sex interaction, such that female sex was only associated with increased stroke hazard at age >70 years. Adjusting for markers of cardiovascular care and multimorbidity further decreased the HR, so that female sex was not associated with increased stroke hazard at age ≤80 years. Conclusion Older age and inequities in cardiovascular care may partly explain higher stroke rates in females with AF. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 0195668X
- Volume :
- 45
- Issue :
- 2
- Database :
- Complementary Index
- Journal :
- European Heart Journal
- Publication Type :
- Academic Journal
- Accession number :
- 174642960
- Full Text :
- https://doi.org/10.1093/eurheartj/ehad508