Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Gender-Based Clinical, Therapeutic Strategies and Prognosis Differences in Atrial Fibrillation

Aurelio Quesada
*,† ,
Javier Quesada-Ocete
† ORCID logo ,
Blanca Quesada-Ocete
,
Victor Del Moral-Ronda
,
Javier Jiménez-Bello
,
Ricardo Rubini-Costa
,
Carl J. Lavie
,
Daniel P. Morin
,
Fernando De la Guía-Galipienso
ORCID logo ,
Ricardo Rubini-Puig
,
Fabian Sanchis-Gomar
* ORCID logo
†
These authors contributed equally to this work.
Version 1 : Received: 16 August 2023 / Approved: 17 August 2023 / Online: 17 August 2023 (07:15:22 CEST)

A peer-reviewed article of this Preprint also exists.

Quesada, A.; Quesada-Ocete, J.; Quesada-Ocete, B.; del Moral-Ronda, V.; Jiménez-Bello, J.; Rubini-Costa, R.; Lavie, C.J.; Morin, D.P.; de la Guía-Galipienso, F.; Rubini-Puig, R.; Sanchis-Gomar, F. Gender-Based Clinical, Therapeutic Strategies and Prognosis Differences in Atrial Fibrillation. J. Cardiovasc. Dev. Dis. 2023, 10, 434. Quesada, A.; Quesada-Ocete, J.; Quesada-Ocete, B.; del Moral-Ronda, V.; Jiménez-Bello, J.; Rubini-Costa, R.; Lavie, C.J.; Morin, D.P.; de la Guía-Galipienso, F.; Rubini-Puig, R.; Sanchis-Gomar, F. Gender-Based Clinical, Therapeutic Strategies and Prognosis Differences in Atrial Fibrillation. J. Cardiovasc. Dev. Dis. 2023, 10, 434.

Abstract

Background: There is limited data on gender-based differences in atrial fibrillation (AF) treatment and prognosis. Our aim was to examine gender-related differences in medical attention in emergency department (ED) and follow-up (FU) among patients diagnosed with an AF episode and to determine whether there are gender-related differences in clinical characteristics, therapeutic strategies and long-term adverse events in this population. Methods: We performed a retrospective observational study of patients who presented to a tertiary hospital ER for AF from 2010-2015, with a minimum FU of one year. Data on medical attention received, mortality and other adverse outcomes were collected and analyzed. Results: Among the 2 013 patients selected, 1232 (60%) was female. Women were less likely than men to be evaluated by a cardiologist during the ED visit (11.5% vs. 16.6%, p=0.001) and were less likely to be admitted (5.9% vs. 9.5%, p<0.05). Electrical cardioversion was performed more frequently in men, both during the first episode (3.4% vs. 1.2%, p=0.001) and during FU (15.9% vs. 10.6%, p<0.001), in spite of a lower AF recurrence rate in women (9.9% vs 18.1%). During FU, women had more hospitalizations for heart failure (26.2% vs. 16.1%, p<0.001). Conclusions: In patients with AF, although no gender differences in mortality, there were significant differences in clinical outcomes, medical attention received, and therapeutic strategies. Women underwent fewer attempts at cardioversion, had a lower probability of being evaluated by cardiologists and showed a higher probability of hospitalization for heart failure. Being alert to these iniquities should facilitate to adopt measures to correct them.

Keywords

atrial fibrillation; gender; electrical cardioversion; heart failure; mortality

Subject

Medicine and Pharmacology, Cardiac and Cardiovascular Systems

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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