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  1. Article: Epidemiology, diagnosis, and management of atrial fibrillation in women.

    Poli, Daniela / Antonucci, Emilia

    International journal of women's health

    2015  Volume 7, Page(s) 605–614

    Abstract: Atrial fibrillation (AF) is the most common arrhythmia and has become a serious public health ... between AF in women and in men, particularly in elderly women. Elderly women have higher blood pressure ... patients, and examines factors contributing to different stroke risk, diagnosis, and prognosis ...

    Abstract Atrial fibrillation (AF) is the most common arrhythmia and has become a serious public health problem. Moreover, epidemiological data demonstrate that incidence and prevalence of AF are increasing. Several differences in epidemiological patterns, clinical manifestations, and incidence of stroke have been reported between AF in women and in men, particularly in elderly women. Elderly women have higher blood pressure than men and a higher prevalence of heart failure with preserved ejection fraction, both independent risk factors for stroke. On the basis of the evidence on the higher stroke risk among AF in women, recently, female sex has been accepted as a risk factor for stroke and adopted to stratify patients, especially if they are not at high risk for stroke. This review focuses on available evidence on sex differences in AF patients, and examines factors contributing to different stroke risk, diagnosis, and prognosis of arrhythmia in women, with the aim to provide an analysis of the available evidence.
    Language English
    Publishing date 2015-06-11
    Publishing country New Zealand
    Document type Journal Article ; Review
    ZDB-ID 2508161-5
    ISSN 1179-1411
    ISSN 1179-1411
    DOI 10.2147/IJWH.S45925
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  2. Article ; Online: Epidemiology, management, and outcomes of atrial fibrillation among 30 million citizens in Shanghai, China from 2015 to 2020: A medical insurance database study.

    Chen, Mu / Li, Cheng / Liao, Peng / Cui, Xin / Tian, Wenqi / Wang, Qunshan / Sun, Jian / Yang, Mei / Luo, Li / Wu, Hong / Li, Yi-Gang

    The Lancet regional health. Western Pacific

    2022  Volume 23, Page(s) 100470

    Abstract: ... related outcomes in Shanghai are high. Management of AF is markedly improved in recent years, and was not ... management, and outcomes of AF.: Funding: Shanghai Hospital Development Center, National Natural Science ... Background: Atrial fibrillation(AF) has become a significant public health concern in China ...

    Abstract Background: Atrial fibrillation(AF) has become a significant public health concern in China, with population aging and urbanization.
    Methods: Data screening was performed for 30,244,930 subjects with medical insurance in the Shanghai Municipal Health Commission database between 2015 and 2020. Patients diagnosed with AF were identified and further assessed for treatment information and clinical outcomes, as well as sex differences and impact of COVID-19 pandemic on AF managment.
    Findings: AF prevalence was 0.88% in Shanghai, which increased with age and reached 6.70% at subjects 80 years and over. AF was more prevalent in women compared with men (0.89% vs. 0.88%, p<0.0001), which could be attributed to higher AF burden in women over 80 years. Driven by increased prescription of non-vitamin K antagonist oral anticoagulants, anticoagulant use increased from 19.46% in 2015 to 56.57% in 2020. The number of left atrial appendage closure increased from 0.16% in 2015 to 1.23% in 2020. Rhythm control strategy was increasingly adopted, as the use of antiarrhythmic drugs doubled and ablation increased by 21% in 2020 compared to 2015. Compared with men, women were less prone to receive rhythm control treatments, including antiarrhythmics, ablation and cardioversion, but more likely to adopt rate control drugs. During the 5.5 years follow-up, the incidences of stroke, transient ischemic attack, systemic embolism, bleeding, myocardial infarction, and in-hospital death were 6.09%, 5.74%, 1.44%, 5.11%, 8.41%, and 12.84% in patients with index diagnosis of AF in 2015, respectively.
    Interpretation: The burdens of AF and AF-related outcomes in Shanghai are high. Management of AF is markedly improved in recent years, and was not or only slightly impeded by the COVID-19 pandemic. There are sex differences in the prevalence, management, and outcomes of AF.
    Funding: Shanghai Hospital Development Center, National Natural Science Foundation of China and Shanghai Municipal Science and Technology Commission.
    Language English
    Publishing date 2022-05-03
    Publishing country England
    Document type Journal Article
    ISSN 2666-6065
    ISSN (online) 2666-6065
    DOI 10.1016/j.lanwpc.2022.100470
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  3. Article ; Online: Epidemiology, management, and outcomes of atrial fibrillation among 30 million citizens in Shanghai, China from 2015 to 2020

    Mu Chen / Cheng Li / Peng Liao / Xin Cui / Wenqi Tian / Qunshan Wang / Jian Sun / Mei Yang / Li Luo / Hong Wu / Yi-Gang Li

    The Lancet Regional Health. Western Pacific, Vol 23, Iss , Pp 100470- (2022)

    A medical insurance database study

    2022  

    Abstract: ... outcomes in Shanghai are high. Management of AF is markedly improved in recent years, and was not or only ... slightly impeded by the COVID-19 pandemic. There are sex differences in the prevalence, management, and ... Summary: Background: Atrial fibrillation(AF) has become a significant public health concern ...

    Abstract Summary: Background: Atrial fibrillation(AF) has become a significant public health concern in China, with population aging and urbanization. Methods: Data screening was performed for 30,244,930 subjects with medical insurance in the Shanghai Municipal Health Commission database between 2015 and 2020. Patients diagnosed with AF were identified and further assessed for treatment information and clinical outcomes, as well as sex differences and impact of COVID-19 pandemic on AF managment. Findings: AF prevalence was 0.88% in Shanghai, which increased with age and reached 6.70% at subjects 80 years and over. AF was more prevalent in women compared with men (0.89% vs. 0.88%, p<0.0001), which could be attributed to higher AF burden in women over 80 years. Driven by increased prescription of non-vitamin K antagonist oral anticoagulants, anticoagulant use increased from 19.46% in 2015 to 56.57% in 2020. The number of left atrial appendage closure increased from 0.16% in 2015 to 1.23% in 2020. Rhythm control strategy was increasingly adopted, as the use of antiarrhythmic drugs doubled and ablation increased by 21% in 2020 compared to 2015. Compared with men, women were less prone to receive rhythm control treatments, including antiarrhythmics, ablation and cardioversion, but more likely to adopt rate control drugs. During the 5.5 years follow-up, the incidences of stroke, transient ischemic attack, systemic embolism, bleeding, myocardial infarction, and in-hospital death were 6.09%, 5.74%, 1.44%, 5.11%, 8.41%, and 12.84% in patients with index diagnosis of AF in 2015, respectively. Interpretation: The burdens of AF and AF-related outcomes in Shanghai are high. Management of AF is markedly improved in recent years, and was not or only slightly impeded by the COVID-19 pandemic. There are sex differences in the prevalence, management, and outcomes of AF. Funding: Shanghai Hospital Development Center, National Natural Science Foundation of China and Shanghai Municipal Science and Technology Commission.
    Keywords Cardiovascular disease ; Prevalence ; Arrhythmia ; Anticoagulation ; Ablation ; Left atrial appendage closure ; Public aspects of medicine ; RA1-1270
    Subject code 360
    Language English
    Publishing date 2022-06-01T00:00:00Z
    Publisher Elsevier
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: Atrial fibrillation-related stroke in women: Evidence and inequalities in epidemiology, mechanisms, clinical presentation, and management.

    Kostopoulou, Anna / Zeljko, Hrvojka M / Bogossian, Harilaos / Ciudin, Radu / Costa, Francisco / Heijman, Jordi / Kochhaeuser, Simon / Manola, Sime / Scherr, Daniel / Sohal, Manav / Wakili, Reza / Wolf, Michael / Irfan, Ghazala

    Clinical cardiology

    2019  Volume 43, Issue 1, Page(s) 14–23

    Abstract: Background: Atrial fibrillation (AF) is the most common clinical arrhythmia and one of the major ... highlights current knowledge gaps in AF-related stroke mechanisms, prevention and management that warrant ... clear from randomized studies that women benefit from anticoagulant treatment and that their bleeding ...

    Abstract Background: Atrial fibrillation (AF) is the most common clinical arrhythmia and one of the major causes of stroke, heart failure, sudden death, and cardiovascular morbidity. Despite substantial advances in (interventional) rhythm control treatment during the last decade, anticoagulation for stroke prevention remains a major component of AF treatment.
    Hypothesis: There are important sex-specific differences in AF-related stroke, resulting from sex-specific mechanisms and therapeutic differences.
    Methods: This review summarizes available data on sex differences in risk assessment and prevention of stroke and highlights current knowledge gaps in AF-related stroke mechanisms, prevention and management that warrant further research.
    Results: Increased thrombotic risk in women is multifactorial, involving hormonal changes after menopause, structural, endocrine and lifestyle/social factors and their interactions. It is clear from randomized studies that women benefit from anticoagulant treatment and that their bleeding risk is similar to men. Women should therefore receive equivalent treatment to men, based on the validated criteria for anticoagulation therapy. However, women are not represented equally in the large randomized studies and sex-related information in many fields is lacking.
    Conclusions: Female sex is an established risk factor for stroke in AF patients. The evidence for sex-specific differences in stroke risk assessment and stroke prevention is accumulating. However, the underlying biological mechanisms remain incompletely understood and further studies are required in order to decrease AF-related morbidity and mortality.
    MeSH term(s) Anticoagulants/therapeutic use ; Atrial Fibrillation/complications ; Atrial Fibrillation/diagnosis ; Atrial Fibrillation/epidemiology ; Atrial Fibrillation/physiopathology ; Female ; Humans ; Risk Assessment ; Risk Factors ; Sex Factors ; Stroke/diagnosis ; Stroke/epidemiology ; Stroke/etiology ; Stroke/prevention & control
    Chemical Substances Anticoagulants
    Language English
    Publishing date 2019-11-06
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 391935-3
    ISSN 1932-8737 ; 0160-9289
    ISSN (online) 1932-8737
    ISSN 0160-9289
    DOI 10.1002/clc.23284
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  5. Article: Epidemiology of heart failure and trends in diagnostic work-up: a retrospective, population-based cohort study in Sweden.

    Lindmark, Krister / Boman, Kurt / Olofsson, Mona / Törnblom, Michael / Levine, Aaron / Castelo-Branco, Anna / Schlienger, Raymond / Bruce Wirta, Sara / Stålhammar, Jan / Wikström, Gerhard

    Clinical epidemiology

    2019  Volume 11, Page(s) 231–244

    Abstract: ... 2005 and 2013, while death from HF and atrial fibrillation/flutter increased (: Conclusion ... men vs women 1.07 [95% CI 1.06-1.09] and CVD-related mortality subdistribution HR for men vs women 1 ... epidemiological trends persist and remain to ensure proper diagnostic evaluation and management of patients ...

    Abstract Purpose: The purpose of this study was to examine the trends in heart failure (HF) epidemiology and diagnostic work-up in Sweden.
    Methods: Adults with incident HF (≥2 ICD-10 diagnostic codes) were identified from linked national health registers (cohort 1, 2005-2013) and electronic medical records (cohort 2, 2010-2015; primary/secondary care patients from Uppsala and Västerbotten). Trends in annual HF incidence rate and prevalence, risk of all-cause and cardiovascular disease (CVD)-related 1-year mortality and use of diagnostic tests 6 months before and after first HF diagnosis (cohort 2) were assessed.
    Results: Baseline demographic and clinical characteristics were similar for cohort 1 (N=174,537) and 2 (N=8,702), with mean ages of 77.4 and 76.6 years, respectively; almost 30% of patients were aged ≥85 years. From 2010 to 2014, age-adjusted annual incidence rate of HF/1,000 inhabitants decreased (from 3.20 to 2.91, cohort 1; from 4.34 to 3.33, cohort 2), while age-adjusted prevalence increased (from 1.61% to 1.72% and from 2.15% to 2.18%, respectively). Age-adjusted 1-year all-cause and CVD-related mortality was higher in men than in women among patients in cohort 1 (all-cause mortality hazard ratio [HR] men vs women 1.07 [95% CI 1.06-1.09] and CVD-related mortality subdistribution HR for men vs women 1.04 [95% CI 1.02-1.07], respectively). While 83.5% of patients underwent N-terminal pro-B-type natriuretic peptide testing, only 36.4% of patients had an echocardiogram at the time of diagnosis, although this increased overtime. In the national prevalent HF population (patients with a diagnosis in 1997-2004 who survived into the analysis period; N=273,999), death from ischemic heart disease and myocardial infarction declined between 2005 and 2013, while death from HF and atrial fibrillation/flutter increased (
    Conclusion: The annual incidence rate of HF declined over time, while prevalence of HF has increased, suggesting that patients with HF were surviving longer over time. Our study confirms that previously reported epidemiological trends persist and remain to ensure proper diagnostic evaluation and management of patients with HF.
    Language English
    Publishing date 2019-03-22
    Publishing country New Zealand
    Document type Journal Article
    ZDB-ID 2494772-6
    ISSN 1179-1349
    ISSN 1179-1349
    DOI 10.2147/CLEP.S170873
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  6. Article ; Online: Atrial fibrillation in women: epidemiology, pathophysiology, presentation, and prognosis.

    Ko, Darae / Rahman, Faisal / Schnabel, Renate B / Yin, Xiaoyan / Benjamin, Emelia J / Christophersen, Ingrid E

    Nature reviews. Cardiology

    2016  Volume 13, Issue 6, Page(s) 321–332

    Abstract: Atrial fibrillation (AF) is the most common sustained arrhythmia in women and men worldwide. During ... women and men with AF has received less attention. We review the current literature on sex-specific ... in the risk factors and complications of AF, and ultimately aid more-tailored management of the arrhythmia. ...

    Abstract Atrial fibrillation (AF) is the most common sustained arrhythmia in women and men worldwide. During the past century, a range of risk factors has been associated with AF, severe complications from the arrhythmia have been identified, and its prevalence has been increasing steadily. Whereas evidence has accumulated regarding sex-specific differences in coronary heart disease and stroke, the differences between women and men with AF has received less attention. We review the current literature on sex-specific differences in the epidemiology of AF, including incidence, prevalence, risk factors, and genetics, and in the pathophysiology and the clinical presentation and prognosis of patients with this arrhythmia. We highlight current knowledge gaps and areas that warrant future research, which might advance understanding of variation in the risk factors and complications of AF, and ultimately aid more-tailored management of the arrhythmia.
    MeSH term(s) Atrial Fibrillation/diagnosis ; Atrial Fibrillation/epidemiology ; Atrial Fibrillation/genetics ; Atrial Fibrillation/physiopathology ; Female ; Humans ; Incidence ; Prevalence ; Prognosis ; Risk Factors ; Sex Factors
    Language English
    Publishing date 2016-04-07
    Publishing country England
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Review
    ZDB-ID 2490375-9
    ISSN 1759-5010 ; 1759-5002
    ISSN (online) 1759-5010
    ISSN 1759-5002
    DOI 10.1038/nrcardio.2016.45
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  7. Article: [Epidemiology and prognosis of atrial fibrillation in Japanese population].

    Sakamoto, Tamotsu / Inoue, Hiroshi

    Nihon rinsho. Japanese journal of clinical medicine

    2013  Volume 71, Issue 1, Page(s) 15–20

    Abstract: ... of age, affecting approximately 4 % in men and 2 % in women aged 80 years or more. Rhythm control ... risk factors, clinical course and prognosis of AF is very important to management of AF. ... Atrial fibrillation (AF) is one of the common arrhythmias encountered in general practice as well ...

    Abstract Atrial fibrillation (AF) is one of the common arrhythmias encountered in general practice as well as in the field of cardiology. AF could be responsible for increased mortality and various morbidities including clinical symptoms, impaired cardiac function and thromboembolism. An epidemiological study showed that prevalence of AF increased with the aging of the population and that the increase became striking after 60 years of age, affecting approximately 4 % in men and 2 % in women aged 80 years or more. Rhythm control with antiarrhythmic drugs and/or catheter ablation could not fully prevent AF reccurence. Understanding the epidemiology, risk factors, clinical course and prognosis of AF is very important to management of AF.
    MeSH term(s) Age Distribution ; Asian Continental Ancestry Group ; Atrial Fibrillation/diagnosis ; Atrial Fibrillation/epidemiology ; Humans ; Prevalence ; Prognosis ; Sex Factors
    Language Japanese
    Publishing date 2013-01
    Publishing country Japan
    Document type English Abstract ; Journal Article ; Review
    ZDB-ID 390903-7
    ISSN 0047-1852
    ISSN 0047-1852
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  8. Article ; Online: Epidemiology, diagnosis, and management ofatrialfibrillation in women

    Poli D / Antonucci E

    International Journal of Women's Health, Vol 2015, Iss default, Pp 605-

    2015  Volume 614

    Abstract: ... to different stroke risk, diagnosis, and prognosis of arrhythmia in women, with the aim to provide an analysis ... University of Florence, Florence, Italy Abstract: Atrial fibrillation (AF) is the most common arrhythmia and ... manifestations, and incidence of stroke have been reported between AF in women and in men, particularly ...

    Abstract Daniela Poli,1 Emilia Antonucci2 1Thrombosis Centre, Department of Heart and Vessels, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy; 2Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy Abstract: Atrial fibrillation (AF) is the most common arrhythmia and has become a serious public health problem. Moreover, epidemiological data demonstrate that incidence and prevalence of AF are increasing. Several differences in epidemiological patterns, clinical manifestations, and incidence of stroke have been reported between AF in women and in men, particularly in elderly women. Elderly women have higher blood pressure than men and a higher prevalence of heart failure with preserved ejection fraction, both independent risk factors for stroke. On the basis of the evidence on the higher stroke risk among AF in women, recently, female sex has been accepted as a risk factor for stroke and adopted to stratify patients, especially if they are not at high risk for stroke. This review focuses on available evidence on sex differences in AF patients, and examines factors contributing to different stroke risk, diagnosis, and prognosis of arrhythmia in women, with the aim to provide an analysis of the available evidence. Keywords: anticoagulants, bleeding, hypertension, stroke
    Keywords Gynecology and obstetrics ; RG1-991 ; Medicine ; R
    Subject code 610
    Language English
    Publishing date 2015-06-01T00:00:00Z
    Publisher Dove Medical Press
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  9. Article ; Online: Sex Differences in the Epidemiology of New-Onset In-Hospital Post-Coronary Artery Bypass Graft Surgery Atrial Fibrillation: A Large Multicenter Study.

    Filardo, Giovanni / Ailawadi, Gorav / Pollock, Benjamin D / da Graca, Briget / Sass, Danielle M / Phan, Teresa K / Montenegro, Debbie E / Thourani, Vinod / Damiano, Ralph

    Circulation. Cardiovascular quality and outcomes

    2016  Volume 9, Issue 6, Page(s) 723–730

    Abstract: ... differences in outcome in women versus men after CABG, little is known about the sex-specific incidence and ... and 27.4% (827/3022) in women. After adjustment for Society of Thoracic Surgeons-recognized ... At 48 hours, AF-free probabilities were 77% for women and 72% for men (: Conclusions: These novel ...

    Abstract Background: New-onset atrial fibrillation (AF) after coronary artery bypass graft surgery (CABG) is associated with increased morbidity and poorer long-term survival. Although many studies show differences in outcome in women versus men after CABG, little is known about the sex-specific incidence and characteristics of post-CABG AF.
    Methods and results: Overall, 11 236 consecutive patients without preoperative AF underwent isolated CABG from 2002 to 2010 at 4 US academic medical centers and 1 high-volume specialty cardiac hospital. Data routinely collected for the Society of Thoracic Surgeons database were augmented with details on new-onset post-CABG AF events detected via continuous in-hospital ECG/telemetry monitoring. Unadjusted incidence of post-CABG AF was 29.5% (3312/11 236) overall, 30.2% (2485/8214) in men, and 27.4% (827/3022) in women. After adjustment for Society of Thoracic Surgeons-recognized risk factors, women had significantly lower risk for post-CABG AF (odds ratio [95% confidence interval]=0.75 [0.64-0.89]), shorter first, longest, and total duration of AF episodes (mean difference [95% confidence interval]=-2.7 [-4.7 to -0.8] hours; -4.1 [-6.9 to -1.2] hours; -2.4 [-2.5 to -2.3] hours, respectively). At 48 hours, AF-free probabilities were 77% for women and 72% for men (
    Conclusions: These novel data on sex-specific characteristics of new-onset AF after isolated CABG show that women had lower adjusted risk for post-CABG AF and experienced shorter episodes. Investigation of sex-specific impacts on outcomes is needed to identify optimal strategies for prevention and management to ensure all patients achieve the best possible outcomes.
    MeSH term(s) Academic Medical Centers ; Aged ; Atrial Fibrillation/diagnosis ; Atrial Fibrillation/epidemiology ; Atrial Fibrillation/mortality ; Coronary Artery Bypass/adverse effects ; Coronary Artery Bypass/mortality ; Databases, Factual ; Electrocardiography ; Female ; Hospitals, High-Volume ; Humans ; Inpatients ; Linear Models ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; Odds Ratio ; Propensity Score ; Proportional Hazards Models ; Risk Factors ; Sex Distribution ; Time Factors ; Treatment Outcome ; United States/epidemiology
    Language English
    Publishing date 2016-10-18
    Publishing country United States
    Document type Comparative Study ; Journal Article ; Multicenter Study ; Observational Study ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 2483197-9
    ISSN 1941-7705 ; 1941-7713
    ISSN (online) 1941-7705
    ISSN 1941-7713
    DOI 10.1161/CIRCOUTCOMES.116.003023
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