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Author Notes:

E-mail: Simon.Stewart@bakeridi.edu.au

Conceived and designed the experiments: JB MJC SS.

Performed the experiments: JB MJC SS.

Analyzed the data: JB MJC SS.

Contributed reagents/materials/analysis tools: JB MJC SS.

Wrote the paper: JB MJC KAW SS.

The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing Interests: Simon Stewart is a PLOS ONE Editorial Board member. This does not alter our adherence to all the PLOS ONE policies on sharing data and materials.

Subjects:

Research Funding:

SAFETY is funded by a National Health and Medical Research Council of Australia Program Grant (519823).

In addition, JB, MJC and SS are supported by the National Health and Medical Research Council of Australia.

This research is supported in part by the Victorian Government’s Operational Infrastructure Support Program.

Keywords:

  • Science & Technology
  • Multidisciplinary Sciences
  • Science & Technology - Other Topics
  • MULTIDISCIPLINARY SCIENCES
  • CORONARY-HEART-DISEASE
  • ACUTE MYOCARDIAL-INFARCTION
  • MILD COGNITIVE IMPAIRMENT
  • RISK-FACTORS
  • CARDIOVASCULAR-DISEASE
  • RANDOMIZED-TRIAL
  • SEX-DIFFERENCES
  • STROKE
  • PREVENTION
  • ANTICOAGULATION

Women Versus Men with Chronic Atrial Fibrillation: Insights from the Standard Versus Atrial Fibrillation spEcific managemenT studY (SAFETY)

Tools:

Journal Title:

PLoS ONE

Volume:

Volume 8, Number 5

Publisher:

, Pages e65795-e65795

Type of Work:

Article | Final Publisher PDF

Abstract:

Background:Gender-based clinical differences are increasingly being identified as having significant influence on the outcomes of patients with cardiovascular disease (CVD), including atrial fibrillation (AF).Objective:To perform detailed clinical phenotyping on a cohort of hospitalised patients with chronic forms of AF to understand if gender-based differences exist in the clinical presentation, thrombo-embolic risk and therapeutic management of high risk patients hospitalised with chronic AF.Methods:We are undertaking the Standard versus Atrial Fibrillation spEcific managemenT studY (SAFETY) - a multi-centre, randomised controlled trial of an AF-specific management intervention versus usual care. Extensive baseline profiling of recruited patients was undertaken to identify gender-specific differences for risk delineation.Results:We screened 2,438 patients with AF and recruited 335 into SAFETY. Of these, 48.1% were women who were, on average, 5 years older than their male counterparts. Women and men displayed divergent antecedent profiles, with women having a higher thrombo-embolic risk but being prescribed similar treatment regimens. More women than men presented to hospital with co-morbid thyroid dysfunction, depression, renal impairment and obesity. In contrast, more men presented with coronary artery disease (CAD) and/or chronic obstructive pulmonary disease (COPD). Even when data was age-adjusted, women were more likely to live alone (odds ratio [OR] 2.33; 95% confidence interval [CI] 1.47 to 3.69), have non-tertiary education (OR 2.69; 95% CI 1.61 to 4.48) and be symptomatic (OR 1.93; 95% CI 1.06 to 3.52).Conclusion:Health care providers should be cognisant of gender-specific differences in an attempt to individualise and, hence, optimise the management of patients with chronic AF and reduce potential morbidity and mortality.

Copyright information:

© 2013 Ball et al.

This is an Open Access work distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/).
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