Michał Mazurek1, Menno V Huisman2, Kenneth J Rothman3, Miney Paquette4, Christine Teutsch5, Hans-Christoph Diener6, Sergio J Dubner7, Jonathan L Halperin8, Kristina Zint9, Lionel Riou França9, Shihai Lu10, Gregory Y H Lip11. 1. Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, United Kingdom; Department of Cardiology, Congenital Heart Diseases and Electrotherapy, Silesian Medical University, Silesian Centre for Heart Diseases, Zabrze, Poland. 2. Department of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The Netherlands. 3. RTI Health Solutions, Research Triangle Institute, Research Triangle Park, NC. 4. Department of Medicine, Boehringer Ingelheim, Burlington, Canada. 5. Department of Clinical Development and Medical Affairs, Boehringer Ingelheim Pharma GmbH und Co KG, Ingelheim, Germany. 6. Department of Neurology, University of Duisburg-Essen, Germany. 7. Clínica y Maternidad Suizo Argentina, Buenos Aires, Argentina. 8. Icahn School of Medicine at Mount Sinai, New York, NY. 9. Global Epidemiology Department, Boehringer Ingelheim, Ingelheim, Germany. 10. Biostatistics and Data Sciences Department, Boehringer Ingelheim Pharmaceuticals, Inc, Ridgefield, Conn. 11. Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, United Kingdom; Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark. Electronic address: g.y.h.lip@bham.ac.uk.
Abstract
AIMS: Data on gender differences in oral anticoagulation for stroke prevention in patients with atrial fibrillation are conflicting, largely limited to regional reports and vitamin K antagonist use. We aimed to analyze gender-specific anticoagulant prescription patterns early following the introduction of non-vitamin K antagonist oral anticoagulants (NOACs) in a large, global registry on atrial fibrillation. METHODS: The Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation (GLORIA-AF) is an international registry program involving patients with newly diagnosed atrial fibrillation (<3 months from arrhythmia onset). We used data from 15,092 consecutive patients (median age, 71.0 years; 45.5% were women) enrolled between 2011 and 2014. Globally, 79.7% of women and 80.2% of men were anticoagulated; the absolute between-gender difference in prevalence of anticoagulant use was -0.5% (95% confidence interval, -1.8% to 0.8%). Vitamin K antagonists were prescribed to 32.8% and 31.9% (NOACs 46.8% and 48.3%) of women and men, respectively. RESULTS: No confounder for the association between gender and anticoagulant prescription was identified. Between-gender differences in anticoagulant use (lower use in women compared with men by decreasing order of magnitude of the difference) were found for CHA2DS2-VASc (congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, stroke/transient ischemic attack, vascular disease, age 65-74 years, sex category [female]) score = 1; CHADS2 (congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, stroke) score = 0; previous bleeding; age <65 years; no history of hypertension; myocardial infarction; coronary artery disease; North America region; and specialist office setting. CONCLUSION: Globally, the prevalence of anticoagulant use is similar in women and men. The decision to prescribe oral anticoagulation seems to depend predominantly on guideline-related differences in stroke risk stratification rather than on gender.
AIMS: Data on gender differences in oral anticoagulation for stroke prevention in patients with atrial fibrillation are conflicting, largely limited to regional reports and vitamin K antagonist use. We aimed to analyze gender-specific anticoagulant prescription patterns early following the introduction of non-vitamin K antagonist oral anticoagulants (NOACs) in a large, global registry on atrial fibrillation. METHODS: The Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation (GLORIA-AF) is an international registry program involving patients with newly diagnosed atrial fibrillation (<3 months from arrhythmia onset). We used data from 15,092 consecutive patients (median age, 71.0 years; 45.5% were women) enrolled between 2011 and 2014. Globally, 79.7% of women and 80.2% of men were anticoagulated; the absolute between-gender difference in prevalence of anticoagulant use was -0.5% (95% confidence interval, -1.8% to 0.8%). Vitamin K antagonists were prescribed to 32.8% and 31.9% (NOACs 46.8% and 48.3%) of women and men, respectively. RESULTS: No confounder for the association between gender and anticoagulant prescription was identified. Between-gender differences in anticoagulant use (lower use in women compared with men by decreasing order of magnitude of the difference) were found for CHA2DS2-VASc (congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, stroke/transient ischemic attack, vascular disease, age 65-74 years, sex category [female]) score = 1; CHADS2 (congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, stroke) score = 0; previous bleeding; age <65 years; no history of hypertension; myocardial infarction; coronary artery disease; North America region; and specialist office setting. CONCLUSION: Globally, the prevalence of anticoagulant use is similar in women and men. The decision to prescribe oral anticoagulation seems to depend predominantly on guideline-related differences in stroke risk stratification rather than on gender.
Authors: Jan Beyer-Westendorf; A John Camm; Keith A A Fox; Jean-Yves Le Heuzey; Sylvia Haas; Alexander G G Turpie; Saverio Virdone; Ajay K Kakkar Journal: Thromb J Date: 2019-04-25
Authors: Yan-Ming Li; Chao Jiang; Liu He; Xin-Xu Li; Xiao-Xia Hou; San-Shuai Chang; Gregory Y H Lip; Xin Du; Jian-Zeng Dong; Chang-Sheng Ma Journal: Med Sci Monit Date: 2019-10-25
Authors: J Antonio González-Hermosillo; Manuel A Baños-González; Milton E Guevara-Valdivia; Jorge A Vázquez-Acosta; Manuel Odín de Los Ríos Ibarra; Kulio A Aguilar-Linares; Carlos Cantú-Brito; José L Leiva-Pons; Gerardo Pozas-Garza; Eddie A Favela-Pérez; Manlio F Márquez Journal: Int J Cardiol Heart Vasc Date: 2019-01-17