Gender-related Differences in Management of Nonvalvular Atrial Fibrillation in an Asian Population
- Author:
Jung Myung LEE
1
;
Tae Hoon KIM
;
Myung Jin CHA
;
Junbeom PARK
;
Jin Kyu PARK
;
Ki Woon KANG
;
Jaemin SHIM
;
Jae Sun UHM
;
Jun KIM
;
Hyung Wook PARK
;
Young Soo LEE
;
Eue Keun CHOI
;
Chang Soo KIM
;
Boyoung JOUNG
;
Jin Bae KIM
Author Information
- Publication Type:Original Article
- Keywords: Atrial fibrillation; Registries; Sex characteristics; Asian ceancestry group; Anticoagulants
- MeSH: Anticoagulants; Asian Continental Ancestry Group; Atrial Fibrillation; Catheter Ablation; Cohort Studies; Drug Therapy; Electric Countershock; Female; Humans; Korea; Male; Patient Acceptance of Health Care; Prospective Studies; Registries; Sex Characteristics; Tertiary Care Centers
- From:Korean Circulation Journal 2018;48(6):519-528
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND AND OBJECTIVES: Gender-related differences in health care utilization for atrial fibrillation (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 non-vitamin K antagonist oral anticoagulant (NOAC) use was more prevalent in women than men (70.4% vs. 62.3%, p < 0.001). Insufficient 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 insufficient NOAC dosing was common in both sex, it was significantly more frequent in women.
