Sex Differences in Presentation, Quality of Life, and Treatment in Chinese Atrial Fibrillation Patients: Insights from the China Atrial Fibrillation Registry Study

strongBACKGROUND/strongThere is a growing recognition of sex-related disparities in atrial fibrillation (AF). However, limited data is available in Chinese AF patients.strongMATERIAL AND METHODS/strongWe compared symptoms, quality of life (QoL), and treatment of AF according to sex from the China AF Registry study.strongRESULTS/strongWe studied 14 723 patients with non-valvular AF, of whom 5645 patients (38.3%) were female. Women were older than men (67.5±10.6ivs/i. 62.2±12.2). Compared to men, women had more comorbidities and a higher proportion of CHA₂DS₂-VASC score ≥2. Women with AF experienced more severe or disabling symptoms than men (33.7%ivs/i. 22.9% in age75 group; 40.3%ivs/i. 28.7% in age ≥75 group; bothiP/i0.0001). After multivariate analysis, women with AF still had lower QoL (OR 0.69; 95%CI, 0.63-0.76;iP/i0.0001). Women tended to have lower rates of ablation and rhythm-control drug use in those aged75 years. Oral anticoagulant use was low and had no sex difference in AF patients with a CHA₂DS₂-VASC score ≥2.strongCONCLUSIONS/strongIn Chinese AF patients, women were older and more symptomatic, and had worse QoL. Despite all these differences, women tended to receive less rhythm-control treatment in those aged75 years. Oral anticoagulant was substantially underused in high stroke risk patients, regardless of sex.