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Gender-related Differences in Management of Nonvalvular Atrial Fibrillation in an Asian Population.

Authors
 Jung Myung Lee  ;  Tae-Hoon Kim  ;  Myung-Jin Cha  ;  Junbeom Park  ;  Jin-Kyu Park  ;  Ki-Woon Kang  ;  Jaemin Shim  ;  Jae-Sun Uhm  ;  Jun Kim  ;  Hyung Wook Park  ;  Young Soo Lee  ;  Eue-Keun Choi  ;  Chang-Soo Kim  ;  Boyoung Joung  ;  Jin-Bae Kim 
Citation
 KOREAN CIRCULATION JOURNAL, Vol.48(6) : 519-528, 2018 
Journal Title
 KOREAN CIRCULATION JOURNAL 
ISSN
 1738-5520 
Issue Date
2018
Keywords
Anticoagulants ; Asian ceancestry group ; Atrial fibrillation ; Registries ; Sex characteristics
Abstract
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 CHA₂DS₂-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 CHA₂DS₂-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.
Files in This Item:
T201803662.pdf Download
DOI
10.4070/kcj.2017.0389
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Chang Soo(김창수) ORCID logo https://orcid.org/0000-0002-5940-5649
Kim, Tae-Hoon(김태훈) ORCID logo https://orcid.org/0000-0003-4200-3456
Uhm, Jae Sun(엄재선) ORCID logo https://orcid.org/0000-0002-1611-8172
Joung, Bo Young(정보영) ORCID logo https://orcid.org/0000-0001-9036-7225
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/165120
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