Women with Afib more susceptible to stroke and major adverse clinical events

  • Marzona I & al.
  • Int J Cardiol
  • 9 Jul 2018

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • This meta-analysis suggests that women with Afib are at increased risk of stroke compared with men.
  • There is an age dependency to this association, with a significant relationship between increasing age and increased risk of stroke in women that is most evident at age>65 years.

Why this matters

  • Afib is the most common sustained cardiac arrhythmia, several studies have suggested that women could be at a greater for stroke and thromboembolic events.

Study design

  • Systematic review and meta-analysis of 44 studies including 993,603 patients (men, n=5,07,670; women, n=4,85,933) with Afib.
  • Patients were assessed for stroke, TE, major bleeding and cardiovascular and all-cause death.
  • Funding: None.

Key results

  • Women patients with Afib showed an increased risk for stroke (HR, 1.24; 95% CI, 1.14-1.36; P<.001 vs men patients.>
  • Women with progressively increasing age (≥65 years) showed a higher risk for stroke (delta HR, 1.01; 95% CI, 1.00-1.03; P=.037 for each year of increasing age) vs men patients.
  • Risk for stroke significantly increased in women between 65-75 years (P=.002) and >75 years (P=.010) vs men.
  • Increased risk for TE was seen in women vs men for European (P=.026) and multinational studies (P=.002).
  • Few studies reported a higher risk for major bleeding (HR, 1.63; 95% CI, 1.03-2.58) and CV death (HR, 2.08; 95% CI, 1.03-4.23) among women vs men.

Limitations

  • Risk for bias.

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