Department of Internal Medicine, Boston Medical Center, Boston University School of Medicine, 72 East Concord Street, Boston, Massachusetts 02118, USA.
Departamento de Produtos Farmacêuticos, Faculdade de Farmácia da Universidade Federal de Minas Gerais, Av. Pres. Antônio Carlos, 6627 - Pampulha, Belo Horizonte - MG, 31270-901, Brazil.
Nat Rev Cardiol. 2017 Feb;14(2):113-124. doi: 10.1038/nrcardio.2016.171. Epub 2016 Oct 27.
Sex-specific differences in the epidemiology, pathophysiology, presentation, prognosis, and treatment of atrial fibrillation (AF) are increasingly recognized. Women with AF generally experience worse symptoms, poorer quality of life, and have higher risk of stroke and death than men with AF. Effective treatment of the arrhythmia in women is critical to reduce the rate of adverse events. We review the current evidence on sex-specific differences in the utilization and outcomes of treatments for AF, including rate-control and rhythm-control strategies, and stroke-prevention therapy. In addition, we provide a critical evaluation of potential disparities and biases in health-care use that might be associated with differences in the outcomes between women and men. We underscore current knowledge gaps that need to be addressed in future studies to improve the management of AF in women. In particular, we suggest several strategies to produce high-quality evidence from randomized clinical trials for women with AF.
性别特异性差异在房颤（AF）的流行病学、病理生理学、临床表现、预后和治疗中越来越受到重视。女性 AF 患者的症状通常更严重，生活质量更差，发生中风和死亡的风险高于男性 AF 患者。有效治疗女性心律失常对于降低不良事件的发生率至关重要。我们回顾了 AF 治疗中利用和结果的性别特异性差异的现有证据，包括节律控制和心率控制策略，以及卒中预防治疗。此外，我们还对与女性和男性之间的结果差异相关的医疗保健使用中潜在的差异和偏见进行了批判性评估。我们强调了需要在未来的研究中解决当前的知识空白，以改善女性 AF 的管理。特别是，我们提出了一些策略，以便从针对女性 AF 的随机临床试验中获得高质量的证据。
