Durán-Bobín Olga, Elices-Teja Juliana, González-Melchor Laila, Vázquez-Caamaño María, Fernández-Obanza Emiliano, González-Babarro Eva, Cabanas-Grandío Pilar, Piñeiro-Portela Miriam, Prada-Delgado Oscar, Gutiérrez-Feijoo Mario, Freire Evaristo, Díaz-Castro Oscar, Muñiz Javier, García-Seara Javier, Gonzalez-Juanatey Carlos
Cardiology Department, Hospital Universitario Lucus Augusti e Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), 27002 Lugo, Spain.
Cardiology Department, Hospital Clínico de Santiago de Compostela, CIBERCV, 15706 A Coruña, Spain.
J Clin Med. 2021 Aug 27;10(17):3846. doi: 10.3390/jcm10173846.
To analyze the clinical profile and therapeutic strategy in atrial fibrillation (AF) according to gender in a contemporaneous patient cohort a prospective, multicenter observational study was performed on consecutive patients diagnosed with AF and assessed by cardiology units in the region of Galicia (Spain). A total of 1007 patients were included, of which 32.3% were women. The mean age of the women was significantly greater than that of the men (71.6 versus 65.7 years; < 0.001), with a higher prevalence of hypertension (HTN) and valve disease. Women more often reported symptoms related to arrhythmia (28.2% in EHRA class I versus 36.4% in men), with a poorer level of symptoms (EHRA classes IIb and III). Thromboembolic risk was significantly higher among women (CHADS-VASc 3 ± 1.3 versus 2 ± 1.5), in the same way as bleeding risk (HAS-BLED 0.83 ± 0.78 versus 0.64 ± 0.78) ( < 0.001), and women more often received anticoagulation therapy (94.1% versus 87.6%; = 0.001). Rhythm control strategies proved significantly less frequent in women (55.8% versus 66.6%; = 0.001), with a lesser electrical cardioversion (ECV) rate (18.4% versus 27.3%; = 0.002). Perceived health status was poorer in women. Women were older and presented greater comorbidity than men, with a greater thromboembolic and bleeding risk. Likewise, rhythm control strategies were less frequent than in men, despite the fact that women had poorer perceived quality of life and were more symptomatic.
为了在一个同期患者队列中根据性别分析心房颤动（AF）的临床特征和治疗策略，我们对西班牙加利西亚地区心脏病科连续诊断为AF并接受评估的患者进行了一项前瞻性、多中心观察性研究。共纳入1007例患者，其中32.3%为女性。女性的平均年龄显著高于男性（71.6岁对65.7岁；P<0.001），高血压（HTN）和瓣膜病的患病率更高。女性更常报告与心律失常相关的症状（EHRA I级中为28.2%，男性为36.4%），症状水平较差（EHRA IIb级和III级）。女性的血栓栓塞风险显著更高（CHADS-VASc评分为3±1.3对2±1.5），出血风险也是如此（HAS-BLED评分为0.83±0.78对0.64±0.78）（P<0.001），并且女性更常接受抗凝治疗（94.1%对87.6%；P = 0.001）。在女性中，节律控制策略的应用明显较少（55.8%对66.6%；P = 0.001），电复律（ECV）率较低（18.4%对27.3%；P = 0.002）。女性的自我感知健康状况较差。女性年龄更大，合并症比男性更多，血栓栓塞和出血风险更高。同样，尽管女性的生活质量自我感知较差且症状更多，但节律控制策略的应用比男性少。
