Gender-related Differences in Management of Nonvalvular Atrial Fibrillation in an Asian Population
- 주제(키워드) Atrial fibrillation , Registries , Sex characteristics , Asian ceancestry group , Anticoagulants
- 주제(기타) Cardiac & Cardiovascular Systems
- 설명문(일반) [Lee, Jung Myung; Kim, Jin-Bae] Kyung Hee Univ, Div Cardiol, Med Coll, 26-6 Kyungheedae Ro, Seoul 02453, South Korea; [Kim, Tae-Hoon; Uhm, Jae-Sun; Joung, Boyoung] Yonsei Univ, Severance Cardiovasc Hosp, Coll Med, Div Cardiol, 50-1 Yonsei Ro, Seoul 03722, South Korea; [Cha, Myung-Jin; Choi, Eue-Keun] Seoul Natl Univ Hosp, Dept Internal Med, Seoul, South Korea; [Park, Junbeom] Ewha Womans Univ, Coll Med, Dept Cardiol, Seoul, South Korea; [Park, Jin-Kyu] Hanyang Univ, Div Cardiol, Med Ctr, Seoul, South Korea; [Kang, Ki-Woon] Eulji Univ Hosp, Div Cardiol, Korea, South Korea; [Shim, Jaemin] Korea Univ, Div Cardiol, Anam Hosp, Seoul, South Korea; [Kim, Jun] Univ Ulsan, Dept Internal Med, Coll Med, Seoul, South Korea; [Park, Hyung Wook] Chonnam Natl Univ, Med Sch, Dept Cardiovasc Med, Gwangju, South Korea; [Lee, Young Soo] Catholic Univ Daegu, Div Cardiol, Daegu, South Korea; [Kim, Chang-Soo] Yonsei Univ, Dept Prevent Med, Coll Med, Seoul, South Korea
- 등재 SCIE, SCOPUS, KCI등재
- 발행기관 KOREAN SOC CARDIOLOGY
- 발행년도 2018
- URI http://www.dcollection.net/handler/ewha/000000151810
- 본문언어 영어
- Published As http://dx.doi.org/10.4070/kcj.2017.0389
초록/요약
Background and Objectives: Gender-related differences in health care utilization for atrial fibrillation (AF) are increasingly recognized. However, large cohort data for examining gender-related differences in AF are lacking in Asian populations. Methods: The Registry for Comparison Study of Drugs for Symptom Control and Complication Prevention of AF (CODE-AF Registry) is a prospective observational cohort-study that enrolled participants at 10 tertiary hospitals in South Korea. Baseline characteristics retrieved from the CODE-AF Registry were analyzed. Results: A total of 6,274 patients were recruited (mean age 67 +/- 11 years, mean CHA(2)DS(2)-VASc score 2.7 +/- 1.7, 63% male, 65% paroxysmal AF) from June 2016 to April 2017. Women underwent less electric cardioversion (12.3% vs. 19.6%, p<0.001), less radiofrequency ablation (12.4% vs. 17.9%, p<0.001), and less antiarrhythmic drug therapy (44.7% vs. 49.5%, p<0.001), despite having more severe symptoms (symptom class III or IV, 45.8% vs. 37.5%, p<0.001). Among patients with a CHA 2 DS 2 -VA score of 2 or more, a slightly higher proportion of women were taking oral anticoagulants than men (85.7% vs. 81.9%, p=0.002), and non-vitamin K antagonist oral anticoagulant (NOAC) use was more prevalent in women than men (70.4% vs. 62.3%, p<0.001). Insufficient NOAC dosing was very common, more so in women than men (61.5% vs. 56.3%, p<0.001). Conclusions: Female patients with AF were treated more conservatively and rhythm control strategies were used less frequently than in males, even though the female patients with AF had more severe symptoms. While insufficient NOAC dosing was common in both sex, it was significantly more frequent in women.
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