Sex-gender and atrial fibrillation treatment in the ATA-AF Study

Abstract

Atrial fibrillation (AF) is the most common cardiac arrhythmia. This analysis aimed to determine the sex-gender differences in patients with AF enrolled in the observational ATAAF study. The study was conducted in 360 centers in Italy. During a 4-week period, all consecutive inpatients and outpatients aged ≥18 years, with a documented primary or secondary diagnosis of AF, were included. A total of 7148 patients (47% females) were enrolled. Females were significantly older, they more frequently needed assistance and were affected with severe cognitive impairment. The preferred anti-arrhythmic strategy in both genders was heart rate control (females: 54.7%, males: 48.4%, p75 was not (1.00, 95% CI 0.79-1.26). This study defines sex-gender differences in AF patients, including lower OAC prescription in females despite of higher thrombotic risk. Concomitant higher hemorrhagic risk and other characteristics that were more frequent in females (i.e. severe cognitive and functional impairment) may at least partly explain this trend towards gender-related under-prescription of OAC.