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Background.Among patients with atrial fibrillation (AF), women are at higher risk of stroke than men. Using prospective cohort data from a large global population of patients with nonvalvular AF, we sought to identify any differences in the use of anticoagulants for stroke prevention in women and men. Methods and Results.This was a prospective multicenter observational registry with 858 randomly selected sites in 30 countries. A total of 17 184 patients with newly diagnosed (.6 weeks) nonvalvular AF and .1 additional investigatordefined stroke risk factor(s) were recruited (March 2010 to June 2013). The main outcome measure was the use of anticoagulants (Vitamin K antagonists, factor Xa inhibitors, and direct thrombin inhibitors) for stroke prevention at AF diagnosis. Of 17 184 patients enrolled, 43.8% were women. More women than men were at moderate-to-high risk of stroke (CHADS2 score .2: 65.1% versus 54.7%). Rates of anticoagulant use were not different overall (60.9% of men versus 60.8% of women) and in patients with a CHADS2 score .2 (adjusted odds ratio for women versus men, 1.00; 95% confidence interval, 0.92.1.09). In patients at low risk (CHA2DS2-VASc of 0 in men and 1 in women), 41.8% of men and 41.1% of women received an anticoagulant. In patients at high risk (CHA2DS2-VASc score .2), 35.4% of men and 38.4% of women did not receive an anticoagulant. Conclusions.These contemporary global data show that anticoagulant use for stroke prevention is no different in men and women with nonvalvular AF. Thromboprophylaxis was, however, suboptimal in substantial proportions of men and women, with underuse in those at moderate-to-high risk of stroke and overuse in those at low risk.
Does sex affect anticoagulant use for stroke prevention in nonvalvular atrial fibrillation?: The prospective global anticoagulant registry in the FIELD-Atrial Fibrillation
Lip G. Y. H.;Rushton-Smith S. K.;Goldhaber S. Z.;Fitzmaurice D. A.;Mantovani L. G.;Goto S.;Haas S.;Bassand J. -P.;Camm A. J.;Ambrosio G.
Conceptualization
;Jansky P.;Al Mahmeed W.;Oh S.;Van Eickels M.;Raatikainen P.;Steffel J.;Oto A.;Kayani G.;Accetta G.;Kakkar A. K.;Hacke W.;Misselwitz F.;Turpie A. G.;Verheugt F. W.;Fox K. A.;Gersh B. J.;Luciardi H. L.;Cools F.;Corbalan R.;Keltai M.;Kakkar S.;Panchenko E.;Lim T. W.;Jacobson B.;Angchaisuksiri P.;Parkhomenko A.;Barretto A. C.;Sanchez Diaz C. J.;Atar D.;Hu D.;Agnelli G.;Darius H.;Gibbs H.;Ten Cate H.;Stepinska J.;Le Heuzey J. Y.;Nielsen J. D.;Brodmann M.;Rosenqvist M.;Connolly S. J.;Spyropoulos A.;Eikelboom J.;Vinolas X.;Koretsune Y.;Hu D. Y.;Chen K. N.;Zhao Y. S.;Zhang H. Q.;Chen J. Z.;Cao S. P.;Wang D. W.;Yang Y. J.;Li W. H.;Yin Y. H.;Tao G. Z.;Yang P.;Chen Y. M.;He S. H.;Wang Y.;Fu G. S.;Li X.;Wu T. G.;Cheng X. S.;Yan X. W.;Zhao R. P.;Chen M. S.;Xiong L. G.;Chen P.;Jiao Y.;Guo Y.;Xue L.;Wang F. Z.;Li H.;Yang Z. M.;Jadhav P.;Durgaprasad R.;Ravi Shankar A. G.;Rajput R. K.;Bhargava K.;Sarma R.;Srinivas A.;Roy D.;Nagamalesh U. M.;Chopda M.;Kishore R.;Kulkarni G.;Chandwani P.;Pothiwala R. A.;Padinhare Purayil M.;Shah S.;Chawla K.;Kothiwale V. A.;Raghuraman B.;Vijayaraghavan G.;Vijan V. M.;Sawhney J.;Bantwal G.;Bisne V.;Khan A.
Membro del Collaboration Group
;Gupta J. B.;Kumar S.;Jain D.;Kanamori S.;Yamamoto K.;Kumagai K.;Katsuda Y.;Sadamatsu K.;Toyota F.;Mizuno Y.;Misumi I.;Noguchi H.;Ando S.;Suetsugu T.;Minamoto M.;Oda H.;Shiraishi K.;Adachi S.;Chiba K.;Norita H.;Tsuruta M.;Koyanagi T.;Ando H.;Higashi T.;Okada K.;Azakami S.;Komaki S.;Kumeda K.;Murayama T.;Matsumura J.;Oba Y.;Sonoda R.;Minoda K.;Haraguchi Y.;Suefuji H.;Miyagi H.;Kato H.;Nakamura T.;Nandate H.;Zaitsu R.;Fujiura Y.;Yoshimura A.;Numata H.;Ogawa J.;Tatematsu H.;Kamogawa Y.;Murakami K.;Wakasa Y.;Yamasawa M.;Maekawa H.;Abe S.;Kihara H.;Tsunoda S.;Saito K.;Fudo T.;Obunai K.;Tachibana H.;Oba I.;Kuwahata T.;Higa S.;Gushiken M.;Eto T.;Yoshida H.;Ikeda D.;Ishizawa M.;Nakatsuka M.;Murata K.;Ogurusu C.;Shimoyama M.;Akutsu M.;Takamura I.;Hoshino F.;Yokota N.;Iwao T.;Tsuchida K.;Takeuchi M.;Hatori Y.;Kitami Y.;Nakamura Y.;Oyama R.;Ageta M.;Go Y.;Mishima K.;Unoki T.;Morii S.;Shiga Y.;Sumi H.;Nagatomo T.;Sanno K.;Fujisawa K.;Atsuchi Y.;Nagoshi T.;Seto T.;Tabuchi T.;Kameko M.;Nii K.;Oshiro K.;Takezawa H.;Nagano S.;Miyamoto N.;Iwaki M.;Fujii M.;Okawa M.;Abe M.;Saito T.;Mito T.;Nagao K.;Minami J.;Mita T.;Sakuma I.;Taguchi T.;Marusaki S.;Doi H.;Tanaka M.;Fujito T.;Matsuta M.;Kusumoto T.;Kakinoki S.;Ashida K.;Yoshizawa N.;Agata J.;Arasaki O.;Manita M.;Ikemura M.;Fukuoka S.;Murakami H.;Matsukawa S.;Hata Y.;Taniguchi T.;Ko T.;Kubo H.;Imamaki M.;Akiyama M.;Inagaki M.;Odakura H.;Ueda T.;Katsube Y.;Nakata A.;Watanabe H.;Techigawara M.;Igarashi M.;Taga K.;Kimura T.;Tomimoto S.;Shibuya M.;Nakano M.;Ito K.;Seo T.;Hiramitsu S.;Hosokawa H.;Hoshiai M.;Hibino M.;Miyagawa K.;Horie H.;Sugishita N.;Soma A.;Neya K.;Yoshida T.;Mizuguchi M.;Ishiguro M.;Minagawa T.;Wada M.;Mukawa H.;Okuda F.;Nagasaka S.;Pak H. N.;Kim J. B.;Kim J. H.;Jang S. W.;Kim D. H.;Kim J.;Ryu D. R.;Park S. W.;Kim D. K.;Choi D. J.;Cho M. C.;Kim S. H.;Jeon H. K.;Shin D. G.;Park J. S.;Park H. K.;Han S. J.;Sung J. H.;Cho J. G.;Nam G. B.;On Y. K.;Lim H. E.;Kwak J. J.;Cha T. J.;Hong T. J.;Park S. H.;Yoon J. H.;Kim N. H.;Kim K. S.;Jung B. C.;Hwang G. S.;Kim C. J.;Kim D. B.;Ching C. K.;Foo C. G.;Chow J. H.;Chawanadelert S.;Mongkolwongroj P.;Kanokphatcharakun K.;Cheewatanakornkul S.;Laksomya T.;Pattanaprichakul S.;Chantrarat T.;Rungaramsin S.;Silaruks S.;Wongcharoen W.;Siriwattana K.;Likittanasombat K.;Katekangplu P.;Boonyapisit W.;Cholsaringkarl D.;Chatlaong B.;Chattranukulchai P.;Santanakorn Y.;Hutayanon P.;Khunrong P.;Bunyapipat T.;Jai-Aue S.;Kaewsuwanna P.;Altun A.;Ozdogru I.;Ozdemir K.;Yilmaz O.;Aydinlar A.;Yilmaz M. B.;Yeter E.;Ongen Z.;Cayli M.;Pekdemir H.;Ozdemir M.;Sucu M.;Sayin T.;Demir M.;Yorgun H.;Ersanli M.;Okuyan E.;Aras D.;Vensentini N.;Ingaramo A. C.;Sambadaro G. A.;Fernandez Caputi V.;Berman S. G.;Dragotto P.;Kleiban A. J.;Centurion N.;Giacomi G.;Ahuad Guerrero R. A.;Conde D.;Zapata G.;Di Paola L. A.;Ramos J. L.;Dran R. D.;Egido J.;Fernandez A. A.;Fosco M. J.;Sassone S.;Sinisi V. A.;Cartasegna L. R.;Berli M. A.;Gomez Vilamajo O.;Ferroni F.;Sobral Filho D. C.;Jaber J.;Armaganijan D.;Faria Neto J.;Steffens A.;Kunz Sebba Barroso de Souza W.;de Souza Neto J. D.;Ribeiro J. M.;Silveira Teixeira M.;Ferreira Rossi P. R.;Pires L.;Moreira D.;Moura Jorge J. C.;Menezes Lorga Filho A.;Bodanese L. C.;Westerlund Montera M.;Del Carlo C. H.;Da Rocha Rodrigues T.;Alves da Costa F. A.;Lopes A.;Lopes R.;Araujo G. R.;Fernandes Manenti E. R.;Kerr Saraiva J. F.;Ferreira Braga J. C.;Negri A.;Souto L.;Moncada C.;Bertolim Precoma D.;Roquette F.;Reis G.;Ramos Filho R. A.;Lanna Figueiredo E.;Vieira Botelho R.;Munhoz da Fontoura Tavares C.;Costantini Frack C. R.;Abdalla Saad J.;Finimundi H. C.;Pisani C.;Chemello D.;Pereira Martins M.;Broilo Franca C. C.;Alban F.;Aranha Rosito G. B.;de Moura Xavier Moraes Junior J. B.;Tumelero R. T.;Nigro Maia L.;Simoes de Almeida R.;do Carmo Borges N. C.;Gomes Ferreira L. G.;Eggers G.;Bugueno Gutierrez C.;Arriagada G.;Potthoff Cardenas S.;Stockins Fernandez B. A.;Conejeros C.;Houzvic C.;Marin Cuevas P.;Montecinos H.;Forero A.;Lanas F.;Larico Gomez M.;Charme Vilches G.;Rey C.;Astudillo C.;Aguilar J.;Illescas Diaz J.;Leal Cantu R.;Ramos Zavala M. G.;Cabrera Jardines R.;Espinola Zavaleta N.;Villarreal Umana S.;Lopez Rosas E.;Llamas Esperon G.;Pozas G.;Cardona Munoz E.;Matadamas Hernandez N.;Leyva Rendon A.;Garcia Hernandez N.;de los Rios Ibarra M.;Virgen Carrillo L.;Lopez Villezca D.;Hernandez Herrera C.;Lopez Prieto J. J.;Gaona Rodriguez R.;Villeda Espinosa E.;Flores Martinez D.;Velasco Barcena J.;Yong R.;Rodriguez Briones I.;Leiva Pons J. L.;Alvarez Lopez H.;Olvera-Ruiz R.;Diaz de la Vega C.;Cantu Brito C.;Chuquiure Valenzuela E.;Reyes-Sanchez R.;Bazzoni Ruiz A.;Nandayapa Flores O.;Benavides Gonzalez M.;Arriaga Nava R.;Morales Cerda J. D.;Fierro Fierro O.;Fajardo Campos P.;Lenz K.;Drexel H.;Foechterle J.;Hagn C.;Podczeck-Schweighofer A.;Huber K.;Winkler M.;Schneeweiss B.;Gegenhuber A.;Lang W.;Eichinger-Hasenauer S.;Kaserer P.;Sykora J.;Rasch H.;Pichler M.;Schaflinger E.;Strohmer B.;Paparella G.;Vandergoten P.;Parque J. L.;Capiau L.;Vervoort G.;Wollaert B.;Desfontaines P.;Mairesse G.;Boussy T.;Godart P.;De Wolf A.;Voet J.;Heyse A.;Hollanders G.;Anne W.;Vercammen J.;Purnode P.;Blankoff I.;Faes D.;Balthazar Y.;Beutels M.;Marechal P.;Verstraete S.;Xhaet O.;Striekwold H.;Thoeng J.;Hermans K.;Reichert P.;Spacek R.;Machova V.;Zidkova E.;Ludka O.;Olsr J.;Kotik L.;Plocova K.;Racz B.;Ferkl R.;Hubac J.;Kotik I.;Monhart Z.;Burianova H.;Jerabek O.;Pisova J.;Petrova I.;Dedek V.;Honkova M.;Podrazil P.;Spinar J.;Vitovec J.;Novak M.;Lastuvka J.;Durdil V.;Nielsen J.;Nielsen H.;Husted S.;Hintze U.;Rasmussen S.;Bremmelgaard A.;Markenvard J.;Boerger J.;Solgaard J.;Simonsen P.;Loekkegaard T.;Bruun M.;Mertz J.;Dominguez H.;Skagen K.;Egstrup K.;Ibsen H.;Raymond I.;Airaksinen J.;Galinier M.;Gottwalles Y.;Paganelli F.;Loiselet P.;Muller J. J.;Koujan M. B.;Marquand A.;Destrac S.;Piot O.;Delarche N.;Cebron J. P.;Boveda S.;Guenoun M.;Guedj-Meynier D.;Galley D.;Ohayon J.;Assouline S.;Zuber M.;Amarenco P.;Ellie E.;Kadouch J.;Fournier P. Y.;Huberman J. P.;Lemaire M.;Rodier G.;Milandre L.;Vandamme X.;Sibon I.;Neau J. P.;Mahagne M. H.;Mielot A.;Bonnefoy M.;Churet J. B.;Navarre V.;Sellem F.;Monniot G.;Boyes J. P.;Doucet B.;Martelet M.;Obadia D.;Crousillat B.;Mouallem J.;Bearez E.;Nazeyrollas P.;Brugnaux J. P.;Fedorowsky A.;Casassus F.;Berneau J. B.;Chemin F.;Falvo N.;Perron J. M.;Poulard J. E.;Koniger G.;Purr J.;Gerbaulet U.;Kellner B. T.;Kopf A.;Schafer T.;Zauzig H.;Riegel P.;Hohensee H.;Eissfeller E.;Eder W.;Rehling G.;Glatzel D.;Zutz S.;Heinz G. U.;Menke H.;Pustelnik A.;Sandow P.;Ludwig N.;Wiswedel H.;Wildenauer W.;Axthelm C.;Schwarz T.;Babyesiza A.;Stuchlik G.;Zimny H. H.;Kropp M.;Kahl F.;Caspar A.;Omankowsky S.;Lassig T.;Hartmann H. J.;Lehmann G.;Bindig H. W.;Hergdt G.;Reimer D.;Hauk J.;Dorsch W.;Dshabrailov J.;Michel H.;Rapp J. A.;Vormann R.;Mayer P.;Horstmeier U.;Eissing V.;Hey H.;Leuchtgens H.;Lilienweiss V.;Kolitsch K.;Schubert C.;Lauer H.;Buchner T.;Brauer G.;Kamin S.;Muller K.;Abdel-Qader M.;Baumbach S.;Ebert H. H.;Schwencke C.;Schellong S.;Bernhardt P.;Karolyi L.;Sievers B.;Haverkamp W.;Salbach P.;Rohnisch J. U.;Schoen S.;Erdle W.;Mueller T.;Mueller H.;Mitrovic V.;Vangel S.;Szalai G.;Merkely B.;Kancz S.;Boda Z.;Nagy A.;Laszlo Z.;Matoltsy A.;Gaszner B.;Polgar P.;Habon T.;Noori E.;Juhasz G.;Kanakaridisz N.;Szentpeteri I.;Juhasz F.;Vertes A.;Papp A.;May Z.;Ferenczi J.;Egyutt M.;Kis E.;Engelthaler G.;Szantai G.;Tiraferri E.;Santoro R.
Membro del Collaboration Group
;Testa S.;Di Minno G.;Moia M.;Caimi T. M.;Martini G.
Background.Among patients with atrial fibrillation (AF), women are at higher risk of stroke than men. Using prospective cohort data from a large global population of patients with nonvalvular AF, we sought to identify any differences in the use of anticoagulants for stroke prevention in women and men. Methods and Results.This was a prospective multicenter observational registry with 858 randomly selected sites in 30 countries. A total of 17 184 patients with newly diagnosed (.6 weeks) nonvalvular AF and .1 additional investigatordefined stroke risk factor(s) were recruited (March 2010 to June 2013). The main outcome measure was the use of anticoagulants (Vitamin K antagonists, factor Xa inhibitors, and direct thrombin inhibitors) for stroke prevention at AF diagnosis. Of 17 184 patients enrolled, 43.8% were women. More women than men were at moderate-to-high risk of stroke (CHADS2 score .2: 65.1% versus 54.7%). Rates of anticoagulant use were not different overall (60.9% of men versus 60.8% of women) and in patients with a CHADS2 score .2 (adjusted odds ratio for women versus men, 1.00; 95% confidence interval, 0.92.1.09). In patients at low risk (CHA2DS2-VASc of 0 in men and 1 in women), 41.8% of men and 41.1% of women received an anticoagulant. In patients at high risk (CHA2DS2-VASc score .2), 35.4% of men and 38.4% of women did not receive an anticoagulant. Conclusions.These contemporary global data show that anticoagulant use for stroke prevention is no different in men and women with nonvalvular AF. Thromboprophylaxis was, however, suboptimal in substantial proportions of men and women, with underuse in those at moderate-to-high risk of stroke and overuse in those at low risk.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11591/505472
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