Women with AF at increased risk for acute ischemic stroke hospitalization

The likelihood of hospitalization for acute ischemic stroke is 23% higher in women compared with men, according to results of a 15-year study of patients with atrial fibrillation presented at Cardiostim-EHRA Europace 2016.

“There is evidence from around the world that women with atrial fibrillation receive less anticoagulation for stroke prevention than they need,” Ghanshyam Palamaner Shantha, MBBS, a CVD fellow at the University of Iowa Hospitals and Clinics, said in a press release. “Just 30% of women who should receive this medication actually get it, compared to nearly 60% of men.”

The study, which included data on 1.1 million patients with AF who were hospitalized from 1998 to 2012, used information from the National Inpatient Sample (NIS) to determine whether sex had any bearing on rate of hospitalization in patients with AF and acute ischemic stroke. The NIS reports data from 8 million patients admitted at approximately 1,000 hospitals in 46 states from 1998 to2012.

The rate of hospitalization for acute ischemic stroke in patients with AF during the 15-year period was 2.64% in women vs. 2.15% in men. When the data were adjusted for stroke risk factors such as age, diabetes, hypertension, previous stroke and HF, the researchers found that the risk for hospitalization for acute ischemic stroke was 23% higher in women.

Additionally, the researchers studied the impact of sex on acute ischemic stroke hospitalization over time and found that women consistently had higher risk for stroke hospitalization than men. From 1998 to 2002, women had a 27% higher risk for acute ischemic stroke hospitalization than men, a 23% higher risk in 2003 to 2007 and a 22% higher risk in 2008 to 2012.

The researchers also studied whether differences between men and women persisted in subcategories based on ethnicity, age, socioeconomic status and region. Regardless of these differences, women still showed a higher risk for hospitalization for acute ischemic stroke compared with men.

“However you slice, dice and divide the data, women do poorer than men in terms of admissions for acute ischemic stroke. This was true overall, across different time periods, and in all subcategories,” Shantha said. “There is no particular region where women with AF get worse care. In those with socioeconomic status, women do worse than men, and among those with low socioeconomic status women do worse than men. Women have second-rate outcomes across the board.” – by Dave Quaile

Reference:

Shantha G, et al. Poster 137-01. Presented at: Cardiostim-EHRA Europace, June 8-11, 2016; Nice, France.

Disclosure: Shantha reports no relevant financial disclosures.