OBJECTIVES: Our objective was to examine gender differences in clinical presentation, management and prognosis of atrial fibrillation (AF) in a contemporary cohort. METHODS: In 6412 patients, 39.7% women, of the PREvention oF thromboembolic events - European Registry in Atrial Fibrillation, we examined gender differences in symptoms, risk factors, therapies and 1-year incidence of adverse outcomes. RESULTS: Men with AF were on average younger than women (mean±SD: 70.1±10.7 vs 74.1±9.7 years, p<0.0001). Women more frequently had at least one AF-related symptom at least occasionally compared with men (95.4% in women, 89.8% in men, p<0.0001). Prescription of oral anticoagulation was similar, with an increase of non-vitamin K antagonist oral anticoagulants from 5.9% to 12.6% in women and from 6.2% to 12.6% in men, p<0.0001 for both.Men were more frequently treated with electrical cardioversion and ablation (20.6% and 6.3%, respectively) than women (14.9% and 3.3%, respectively), p<0.0001. Women had 65% (OR: 0.35; 95% CI (0.22 to 0.56)) lower age-adjusted and country-adjusted odds of coronary revascularisation, 40% (OR: 0.60; (0.38 to 0.93)) lower odds of acute coronary syndrome and 20% (OR: 0.80; (0.68 to 0.96)) lower odds of heart failure at 1 year. There were no statistically significant gender differences in 1-year stroke/transient ischaemic attack/arterial thromboembolism and major bleeding events. CONCLUSION: In a 'real-world' European AF registry, women were more symptomatic but less likely to receive invasive rhythm control therapy such as electrical cardioversion or ablation. Further study is needed to confirm that these differences do not disadvantage women with AF.

AFNET Münster Germany

Daiichi Sankyo Europe GmbH Munich Germany

Department of Cardiology Angiology Nephrology and Conservative Intensive Care Medicine Vivantes Klinikum Neukolln Berlin Germany

Department of Cardiology University Heart Center Hamburg Eppendorf German Center for Cardiovascular Research partner site Hamburg Kiel Lübeck Hamburg Germany

Fondazione G Monasterio Pisa Italy

G d'Annunzio University of Chieti Pescara Chieti Italy

Institute of Cardiovascular Sciences University of Birmingham and SWBH and UHB NHS Trust Birmingham UK

Medical Facility Pilsen of Charles University Pilsen Czech Republic

School of Clinical and Experimental Medicine University of Birmingham Birmingham UK

doi: 10.1136/heartjnl-2016-311085 PubMed

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