Turk Kardiyol Dern Ars. 2017; 45(1): 16-25 | DOI: 10.5543/tkda.2016.89894
Gender-related differences in presentation and treatment of patients with non-valvular atrial fibrillation: results from RAMSES study
, Özcan Başaran1
, Osman Beton2
, Mehmet Tekinalp3
, Ahmet Çağrı Aykan4
, Ezgi Kalaycıoğlu4
, İsmail Bolat5
, Onur Taşar6
, Özgen Şafak7
, Macit Kalçık8
, Cevat Kırma9
, Murat Biteker11
Department of Cardiology Mugla Sitki Kocman University, Faculty of Medicine, Mugla Turkey2
Department Of Cardiology Sivas Cumhuriyet University, Faculty Of Medicine Sivas Turkey3
Department Of Cardiology Kahramanmaraş Necip Fazıl State Hospital Kahramanmaraş Turkey4
Department Of Cardiology Trabzon Ahi Evren Chest Cardiovascular Surgery Education And Research Hospital Trabzon Turkey5
Department of Cardiology Fethiye State Hospital Mugla Turkey6
Department of Cardiology Elazığ Education and Research Hospital Elazığ Turkey7
Department of Cardiology Burdur State Hospital Burdur Turkey8
Department Of Cardiology İskilip Atıf Hoca State Hospital Çorum Turkey9
Department Of Cardiology Kartal Kosuyolu Heart Education And Research Hospital İstanbul Turkey
OBJECTIVE Gender is an important feature in the management of atrial fibrillation (AF). This study investigated gender-related differences in patients with AF in Turkey.
METHODS As a part of RAMSES (ReAl-life Multicenter Survey Evaluating Stroke prevention strategies in Turkey, NCT02344901) study, information of the patients with AF who successively applied to the hospital was analyzed. This cross-sectional, multicenter, nationwide observational study enrolled 6264 non-valvular AF (NVAF) outpatients (55.9% women) from Turkey.
RESULTS Compared with men, women with NVAF were older (71 years [range: 6578 years] vs. 70 years [range: 6277 years]; p<0.001), had lower frequency of coronary artery disease (22.0% vs. 38.3%; p<0.001) and congestive heart failure (18.2% vs. 27.2%; p<0.001). Women had higher median CHA2DS2-VASc score (4 [range: 35] vs. 3 [range: 24]; p<0.001), but similar HAS-BLED score (2 [range: 12] vs. 2 [range: 12]; p=0.141) when compared with men. Anticoagulant therapy use was higher in women (74.5% vs. 69.9%; p<0.001). Analysis of anticoagulation therapy use revealed that 68.5% of men and 61.6% of women (p=0.204) who had low risk for stroke (CHA2DS2-VASc score: 0 [male], 1 [female]) received anticoagulation therapy, and 30.5% of the men. Meanwhile, 25.3% of the women (p<0.001) with high risk for stroke (CHA2DS2-VASc score: ≥1 [male], ≥2 [female]) had not received any anticogulant therapy.
CONCLUSION Although women with NVAF receive better treatment than men, anticoagulation therapy is suboptimal in large proportion of men and women, with underuse in high-risk patients and overuse in low-risk patients. There is an urgent need to improve optimization of anticoagulation in patients with NVAF.
Gender, non-valvular atrial fibrillation, oral anticoagulan therapy.
How to cite this article
Volkan Doğan, Özcan Başaran, Osman Beton, Mehmet Tekinalp, Ahmet Çağrı Aykan, Ezgi Kalaycıoğlu, İsmail Bolat, Onur Taşar, Özgen Şafak, Macit Kalçık, Cevat Kırma, Murat Biteker. Gender-related differences in presentation and treatment of patients with non-valvular atrial fibrillation: results from RAMSES study. Turk Kardiyol Dern Ars. 2017; 45(1): 16-25
Corresponding Author: Volkan Doğan, Türkiye