Is prevalence of atrial fibrillation higher in men or women? Which sex is more likely to be asymptomatic? At higher risk for stroke?
Although atrial fibrillation is common in clinical practice, little research has been done on differences between the sexes in symptoms, quality of life, and other domains. A recent analysis of the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF) has helped shed light on the differential impact of AF on men and women. This 3-question quiz is a quick test of what you might, or might not know, about the results.
1. More women than men tend to be asymptomatic with atrial fibrillation.
Answer: B. False
A recent registry analysis of ORBIT-AF (an outpatient registry of 10,135 patients with incident and prevalent AF) found that only 32.1% of women are asymptomatic with AF compared to 42.5% of men. The study also found that women with AF had lower quality of life scores than men.
2. In which sex is prevalence of AF lower?
C. Neither; prevalence is equal in both genders
Answer: B. Women
The prevalence of AF is lower among women regardless of age group. Women also tend to have differential outcomes and differential treatments (ie, fewer pulmonary vein isolation procedures, less anticoagulation).
3. Women with AF are more likely than men to have which of the following?
A. Higher rates of stroke
B. Higher rates of all-cause mortality
C. More frequent time in therapeutic range
D. More cardioversions
Answer: A. Higher rates of stroke
In the ORBIT-AF registry, the rates of anticoagulation and time in therapeutic range were similar for men and women. Despite this, women had a higher rate of stroke (HR 1.39) and a lower adjusted rate of all-cause mortality (HR 0.57). The reasons for these differences need further investigation.
Source: Piccini JP, Simon DN, Steinberg BA, et al. Differences in clinical and functional outcomes of atrial fibrillation in women and men. Two-year results from the ORBIT-AF registry. JAMA Cardiol. [Published online ahead of print May 18, 2016]. Doi:10.1001/jamacardio.2016.0529.