Ischaemic stroke in women with atrial fibrillation : temporal trends and clinical implications

Konsta Teppo, K. E. Juhani Airaksinen, Jussi Jaakkola, O Halminen, Birgitta Salmela, Elis Kouki, Jari Haukka, Jukka Putaala, Miika Linna, Aapo L. Aro, Pirjo Mustonen, Juha Hartikainen, Gregory Y. H. Lip, Mika Lehto

Tutkimustuotos: LehtiartikkeliArticleScientificvertaisarvioitu

6 Sitaatiot (Scopus)
31 Lataukset (Pure)

Abstrakti

Background and Aims

Female sex has been linked with higher risk of ischaemic stroke (IS) in atrial fibrillation (AF), but no prior study has examined temporal trends in the IS risk associated with female sex.

Methods

The registry-linkage Finnish AntiCoagulation in Atrial Fibrillation (FinACAF) study included all patients with AF in Finland from 2007 to 2018. Ischaemic stroke rates and rate ratios were computed.

Results

Overall, 229 565 patients with new-onset AF were identified (50.0% women; mean age 72.7 years). The crude IS incidence was higher in women than in men across the entire study period (21.1 vs. 14.9 events per 1000 patient-years, P < .001), and the incidence decreased both in men and women. In 2007–08, female sex was independently associated with a 20%–30% higher IS rate in the adjusted analyses, but this association attenuated and became statistically non-significant by the end of the observation period. Similar trends were observed when time with and without oral anticoagulant (OAC) treatment was analysed, as well as when only time without OAC use was considered. The decrease in IS rate was driven by patients with high IS risk, whereas in patients with low or moderate IS risk, female sex was not associated with a higher IS rate.

Conclusions

The association between female sex and IS rate has decreased and become non-significant over the course of the study period from 2007 to 2018, suggesting that female sex could be omitted as a factor when estimating expected IS rates and the need for OAC therapy in patients with AF.
AlkuperäiskieliEnglanti
Sivut1819-1827
Sivumäärä9
JulkaisuEuropean Heart Journal
Vuosikerta45
Numero20
Varhainen verkossa julkaisun päivämäärä12 huhtik. 2024
DOI - pysyväislinkit
TilaJulkaistu - 21 toukok. 2024
OKM-julkaisutyyppiA1 Alkuperäisartikkeli tieteellisessä aikakauslehdessä

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