Research highlights gender differences in AF

SAN FRANCISCO — Women with atrial fibrillation appear to have more symptoms and lower quality of life than men with atrial fibrillation, according to an analysis presented at the American College of Cardiology Scientific Sessions.

The finding adds to a growing body of research that highlights gender disparities in the management of CVD.

Jonathan P. Piccini

“Atrial fibrillation is the most common sustained arrhythmia encountered in clinical practice, and the prevalence is increasing in both men and women,” Jonathan P. Piccini, MD, MHSc, assistant professor of medicine and electrophysiology at Duke Clinical Research Institute, told Cardiology Today.

Piccini and colleagues analyzed outcomes data from 10,132 patients with AF from 176 US clinics. About 42% of patients were women. All were enrolled in the long-term, observational ORBIT-AF registry, which was launched in 2010 to better understand outcomes of patients with AF in real-world situations. Researchers enrolled patients from June 2010 to August 2011.

According to 1-year outcomes data presented by Piccini, several disparities emerged between men and women in ORBIT-AF. Compared with men, women in the registry were older (77 vs. 73 years); had greater risk for stroke/transient ischemic attack/systemic embolism; more likely to have paroxysmal AF (54% vs. 48%); had higher symptom burden, including palpitations, dyspnea, exercise intolerance and fatigue; had a slightly higher hospitalization rate; and had more major bleeds.

However, women had less CAD (23% vs. 39%) and sleep apnea (14% vs. 22%) and were less likely to undergo catheter ablation vs. men.

Women reported lower quality of life, based on the Atrial Fibrillation Effect on Quality of Life (AFEQL) score, at both baseline and follow-up.

At 1 year, treatment was similar, with women receiving anticoagulation at a similar frequency as men. However, women had slightly lower time in the therapeutic range.

Despite more symptoms and worse quality of life, women with AF tended to live longer than the men in the study.

Additional studies could help pinpoint the causes of the disparities, Piccini said.

Peter R. Kowey

“More information will be gathered,” Peter R. Kowey, MD, ORBIT-AF steering committee member and Cardiology Today Editorial Board member, said in an interview. “The data will be helpful to clinicians who are seeing women with AF to be aware of the fact that they may have a better outcome overall, but tend to feel worse and have more interference in their life from AF.”

For more information:

Piccini JP. Abstract #751-8. Featured clinical research II: General cardiology. Presented at: American College of Cardiology Scientific Sessions; March 9-11, 2013; San Francisco.

Disclosure: Kowey is on the ORBIT-AF steering committee; he also reports consulting fees/honoraria from Astellas, AstraZeneca, Boehringer Ingelheim, Daiichi Sankyo, Forest Laboratories, GlaxoSmithKline, Johnson & Johnson, Medtronic, Merck, Pfizer, Portola and Sanofi-Aventis. Piccini reports consulting fees/honoraria from Bristol-Myers Squibb/Pfizer, Forest Laboratories, Johnson & Johnson, Medtronic and Spectranetics, and research grants from Johnson & Johnson.