Qinmei Xiong1, Alena Shantsila2, Deirdre A Lane2, Qiongqiong Zhou3, Ying Liu3, Yang Shen3, Xiaoshu Cheng3, Kui Hong3, Gregory Y H Lip4. 1. Cardiovascular Department, The Second Affiliated Hospital of Nanchang University, Nanchang, China; University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham, United Kingdom. 2. University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham, United Kingdom. 3. Cardiovascular Department, The Second Affiliated Hospital of Nanchang University, Nanchang, China. 4. University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham, United Kingdom. Electronic address: g.y.h.lip@bham.ac.uk.
Abstract
BACKGROUND: Limited data exists on the impact of sex on clinical characteristics and outcomes among nonvalvular AF patients from China. We investigated the impact of gender on risk factors and inpatient mortality in a hospitalized nonvalvular AF cohort in Nanchang, China. METHODS: We studied consecutive patients hospitalized with nonvalvular AF between May 2011 and December 2013. Predictors of inpatient mortality were evaluated using multivariate regression analyses. RESULTS: We studied 2442 patients (43.7% female; mean age 71.8), with a median hospital stay of 10 days (IQR: 7-14). Inpatient mortality was 2.2%. Mean age, CHADS2 and CHA2DS2-VASc scores were higher in females vs. males (all p<0.0001). Oral anticoagulation use during hospitalization was 33.3% without sex differences, and length of stay and inpatient outcomes were comparable between sexes. On multivariate analyses, the significant risk factors of inpatient death in females were previous ischemic stroke/transient ischemic attack (TIA)/thromboembolism (TE) (Odds Ratio (OR): 2.27; 95% Confidence Intervals (CI): 1.43-3.61), peripheral artery disease (OR: 5.75, 95% CI: 1.49-22.16) and chronic renal disease (OR: 5.68, 95% CI: 1.46-22.13). Among males, only age (OR: 1.06, 95% CI: 1.02-1.11) and previous ischemic stroke/TIA/TE (OR: 1.81, 95% CI: 1.25-2.63) were independent predictors of inpatient mortality. CONCLUSION: Sex related differences in clinical characteristics and stroke risk profile were evident in Chinese nonvalvular AF patients, but no sex disparity was evident in the low antithrombotic therapy use or inpatient mortality. Previous ischemic stroke/TIA/TE was an important predictor of inpatient mortality in both female and male patients.
BACKGROUND: Limited data exists on the impact of sex on clinical characteristics and outcomes among nonvalvular AFpatients from China. We investigated the impact of gender on risk factors and inpatient mortality in a hospitalized nonvalvular AF cohort in Nanchang, China. METHODS: We studied consecutive patients hospitalized with nonvalvular AF between May 2011 and December 2013. Predictors of inpatient mortality were evaluated using multivariate regression analyses. RESULTS: We studied 2442 patients (43.7% female; mean age 71.8), with a median hospital stay of 10 days (IQR: 7-14). Inpatient mortality was 2.2%. Mean age, CHADS2 and CHA2DS2-VASc scores were higher in females vs. males (all p<0.0001). Oral anticoagulation use during hospitalization was 33.3% without sex differences, and length of stay and inpatient outcomes were comparable between sexes. On multivariate analyses, the significant risk factors of inpatient death in females were previous ischemic stroke/transient ischemic attack (TIA)/thromboembolism (TE) (Odds Ratio (OR): 2.27; 95% Confidence Intervals (CI): 1.43-3.61), peripheral artery disease (OR: 5.75, 95% CI: 1.49-22.16) and chronic renal disease (OR: 5.68, 95% CI: 1.46-22.13). Among males, only age (OR: 1.06, 95% CI: 1.02-1.11) and previous ischemic stroke/TIA/TE (OR: 1.81, 95% CI: 1.25-2.63) were independent predictors of inpatient mortality. CONCLUSION: Sex related differences in clinical characteristics and stroke risk profile were evident in Chinese nonvalvular AFpatients, but no sex disparity was evident in the low antithrombotic therapy use or inpatient mortality. Previous ischemic stroke/TIA/TE was an important predictor of inpatient mortality in both female and male patients.
Authors: Yongchen Hao; Jing Liu; Sidney C Smith; Yong Huo; Gregg C Fonarow; Junbo Ge; Jun Liu; Kathryn A Taubert; Louise Morgan; Yang Guo; Mengge Zhou; Dong Zhao; Changsheng Ma Journal: BMJ Open Date: 2018-07-05 Impact factor: 2.692