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.
References
References
