Shehab Abdulla, Zubaid Mohammad, Bhagavathula Akshaya Srikanth, Rashed Wafa A, Alsheikh-Ali Alawi A, AlMahmeed Wal, Sulaiman Kadhim, Al-Zakwani Ibrahim, AlQudaimi Ahmed, Asaad Nidal, Amin Haitham
Department of Internal Medicine, Faculty of Medicine, UAE University, Al Ain, United Arab Emirates.
Department of Medicine, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait.
PLoS One. 2017 May 17;12(5):e0175405. doi: 10.1371/journal.pone.0175405. eCollection 2017.
Differences in the management of atrial fibrillation (AF) between men and women were investigated by using Gulf SAFE data in the Middle East. The study included 2,043 patients presenting with AF to emergency room (ER) were prospectively enrolled and followed for one-year. Women were older, have higher body mass index (BMI), comorbidities, and health complications than men. With regard to management of AF, cardioversion was recommended more often for men (16.7% vs. 9.3%), and underwent electrical cardioversion (2.2% vs. 1.1%). Women were prescribed digoxin more frequently than men (25.6% vs. 17.4%) and a significant number women received warfarin alone (31.1% vs. 8.7%). No difference between the sexes was noticed in One-year rates of stroke/transient ischemic attacks (TIA) and all-cause of mortality after one-year follow-up (3.1% men vs. 3.3% women, and 7.5% vs. 7.4%). Older age (≥ 65 years), smoking, alcohol use, CHADS2 scores ≥5 were some of the significant risk factors in men with AF. Suboptimal use of anticoagulants, higher mortality and stroke/TIA events at one year are high but similar between the sexes. ER management revealed high use of rate control strategy and high rate of hospital admission was noticed in women.
利用中东地区海湾安全（Gulf SAFE）数据对男性和女性心房颤动（AF）的管理差异进行了调查。该研究前瞻性纳入了2043名因AF就诊于急诊室（ER）的患者，并对其进行了为期一年的随访。女性比男性年龄更大，体重指数（BMI）更高，合并症和健康并发症更多。在AF管理方面，男性更常被推荐进行心脏复律（16.7%对9.3%），且接受电复律的比例更高（2.2%对1.1%）。女性比男性更频繁地被处方使用地高辛（25.6%对17.4%），并且有相当数量的女性仅接受华法林治疗（31.1%对8.7%）。在一年的随访期后，男性和女性的中风/短暂性脑缺血发作（TIA）一年发生率以及全因死亡率没有差异（男性为3.1%，女性为3.3%；男性为7.5%，女性为7.4%）。年龄较大（≥65岁）、吸烟、饮酒、CHADS2评分≥5是AF男性患者的一些显著风险因素。抗凝剂使用不充分、一年时较高的死亡率和中风/TIA事件发生率在两性中都很高，但相似。ER管理显示心率控制策略的使用率很高，并且女性的住院率较高。
