Adam P Deveau1, Robert Sheldon2, Connor Maxey2, Deborah Ritchie2, Steve Doucette3, Ratika Parkash4. 1. Dalhousie University Medical School, Halifax, Nova Scotia, Canada. 2. University of Calgary, Calgary, Alberta, Canada. 3. Research Methods Unit, Nova Scotia Health Authority, Halifax, Nova Scotia, Canada. 4. Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, Canada. Electronic address: Ratika.Parkash@nshealth.ca.
Abstract
BACKGROUND:Vasovagal syncope (VVS) occurs in > 40% of individuals at least once in their lifetime. Sex-dependent differences in presentation and outcomes are not understood. We sought to determine differences in clinical presentation, treatment modalities, and outcomes of VVS between men and women. METHODS: Data were collected as part of the Prevention of Syncope Trials (POST) I and II, 2 multicenter, placebo-controlled, randomized trials testing the effectiveness of metoprolol and fludrocortisone, respectively. Data regarding clinical presentation, outcomes, and time to first syncope event after randomization were compared. RESULTS: Of the 418 patients (280 women and 138 men), women were younger at the time of first syncope event (21 vs 26 years P = 0.002) and had a lower baseline systolic blood pressure (117 vs 124 mm Hg, P < 0.001). Response to heat as a trigger for syncope was more common in women (68% vs 48%, P = 0.011). Clinical presentation in women consisted more commonly of feeling warm, having seizures, and experiencing more postsyncope fatigue (68% vs 54%, P = 0.048; 10% vs 2.7%, P = 0.045; 75% vs 59%, P = 0.017, respectively). Women were more likely to experience recurrent syncope after adjustment for prerandomization syncope burden and randomization assignment (hazard ratio, 1.56; 95% confidence interval, 1.10-2.22; P = 0.012). CONCLUSION: Clinical presentation and provocative factors of VVS differ between men and women, as do recurrent events. Recognition of these differences may help target therapy specifically in men and women.
RCT Entities:
BACKGROUND:Vasovagal syncope (VVS) occurs in > 40% of individuals at least once in their lifetime. Sex-dependent differences in presentation and outcomes are not understood. We sought to determine differences in clinical presentation, treatment modalities, and outcomes of VVS between men and women. METHODS: Data were collected as part of the Prevention of Syncope Trials (POST) I and II, 2 multicenter, placebo-controlled, randomized trials testing the effectiveness of metoprolol and fludrocortisone, respectively. Data regarding clinical presentation, outcomes, and time to first syncope event after randomization were compared. RESULTS: Of the 418 patients (280 women and 138 men), women were younger at the time of first syncope event (21 vs 26 years P = 0.002) and had a lower baseline systolic blood pressure (117 vs 124 mm Hg, P < 0.001). Response to heat as a trigger for syncope was more common in women (68% vs 48%, P = 0.011). Clinical presentation in women consisted more commonly of feeling warm, having seizures, and experiencing more postsyncope fatigue (68% vs 54%, P = 0.048; 10% vs 2.7%, P = 0.045; 75% vs 59%, P = 0.017, respectively). Women were more likely to experience recurrent syncope after adjustment for prerandomization syncope burden and randomization assignment (hazard ratio, 1.56; 95% confidence interval, 1.10-2.22; P = 0.012). CONCLUSION: Clinical presentation and provocative factors of VVS differ between men and women, as do recurrent events. Recognition of these differences may help target therapy specifically in men and women.
Authors: Juliette Hall; Kate M Bourne; Robert S Sheldon; Steven Vernino; Vidya Raj; Jessica Ng; Luis E Okamoto; Amy C Arnold; Meredith Bryarly; Lauren Phillips; Sachin Y Paranjape; Satish R Raj Journal: Clin Auton Res Date: 2021-02-07 Impact factor: 5.625
Authors: Nicola Magnavita; Reparata Rosa Di Prinzio; Gabriele Arnesano; Anna Cerrina; Maddalena Gabriele; Sergio Garbarino; Martina Gasbarri; Angela Iuliano; Marcella Labella; Carmela Matera; Igor Mauro; Franca Barbic Journal: Int J Environ Res Public Health Date: 2021-11-23 Impact factor: 3.390