Older Women With A-Fib at Greater Stroke Risk Than Men

Increased risk based on gender remains, regardless of warfarin use or other risk factors

TUESDAY, May 8 (HealthDay News) -- The risk of stroke following a recent diagnosis of atrial fibrillation (AF) in older patients is higher in women than men, regardless of warfarin use, according to a study published in the May 9 issue of the Journal of the American Medical Association.

Meytal Avgil Tsadok, Ph.D., from McGill University in Montreal, and colleagues used administrative data linked to hospital discharge, physician, and prescription drug claim databases to analyze patients 65 years or older (39,398 men [47.2 percent] and 44,115 women [52.8 percent]) admitted to the hospital with recently diagnosed AF.

The researchers found that, upon admission, women were older and had a significantly higher CHADS2 (congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, prior stroke or transient ischemic attack) score than men (1.99 versus 1.74). At 30-days post-discharge, 58.2 percent of men and 60.6 percent of women had filled a warfarin prescription, which in adjusted analysis was significant (odds ratio, 1.07; 95 percent confidence interval [CI], 1.04 to 1.11). Adherence to warfarin therapy was comparable between the groups. There was a significant sex difference in stroke incidence, with 2.02 strokes per 100 person-years in women compared to 1.61 per 100 person-years in men, which was mainly driven by the population of patients 75 years or older. After adjusting for other variables, including baseline comorbidities, individual elements of the CHADS2 score, and warfarin treatment, women had a significantly higher risk of stroke than men (adjusted hazard ratio, 1.14; 95 percent CI, 1.07 to 1.22).

"Among older patients admitted with recently diagnosed AF, the risk of stroke was greater in women than in men, regardless of warfarin use," the authors write.

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