Elderly Women with Atrial Fibrillation Have a Greater Risk of Stroke than Men
By Matthew E. Fink, MD
This article originally appeared in the June issue of Neurology Alert.
Source: Avgil Tsadok M, et al. Sex differences in stroke risk among older patients with recently diagnosed atrial fibrillation. JAMA 2012;307:1952-1958.
THE REASONS FOR THE HIGHER RISK OF STROKE IN WOMen who have atrial fibrillation (AF), compared to men, is unclear, but under-treatment with warfarin has been suggested as a cause. In a population-based cohort study of patients 65 years or older admitted to the hospital with recently diagnosed AF in Quebec, Canada, from 1998-2007, administrative data were used to link hospital discharge diagnoses with warfarin use. The cohort comprised 39,398 men (47.2%) and 44,115 women (52.8%). On admission, women were older and had a higher CHADS score. At 30 days post-discharge from the hospital, 58.2% of men and 60.6% of women had filled a prescription for warfarin. Adherence to warfarin treatment was good in both male and female groups. Crude stroke incidence was 2.02 per 100 person-years in women (95% confidence interval [CI], 1.95-2.10) vs 1.61 per 100 person-years in men (95% CI, 1.54-1.69, P < 0.001) and was driven by the population of patients 75 years or older.
In a multivariate Cox regression analysis, women had a higher risk of stroke than men (HR = 1.14, 95% CI = 1.07-1.22, P < 0.001) after adjusting for comorbid conditions, individual components of the CHADS score, and warfarin treatment. The risk of stroke was higher in elderly women, compared to men, regardless of warfarin use, but the causes remain undetermined.
THE REASONS FOR THE HIGHER RISK OF STROKE IN WOMen who have atrial fibrillation (AF), compared to men, is unclear, but under-treatment with warfarin has been suggested as a cause.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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