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Sex Differences in Atrial Fibrillation—Update on Risk Assessment, Treatment, and Long-Term Risk

  • Women’s Health (M Wood, Section Editor)
  • Published:
Current Treatment Options in Cardiovascular Medicine Aims and scope Submit manuscript

Abstract

Purpose of review

Atrial fibrillation (AF) is a growing health problem worldwide. While the disease plagues both men and women, this arrhythmia does not affect both sexes equally. Women are more likely to have major adverse outcomes such as stroke and its sequela; however, recent data on stroke prevention show improving outcomes. The purpose of this review of the recent literature is to summarize important updates on risk scores and management of patients with AF.

Recent findings

It has been well known that women have a higher risk of strokes than men when untreated or when treated with warfarin. Current risk scores emphasizing new risk factors such as the higher risk of strokes in women have been incorporated into clinical guidelines. However, with the use of direct oral anticoagulants, this sex disparity on stroke is no longer seen and women have less major bleeding than men. The use of cardiac glycosides is associated with increased incidence of breast cancer, and this medication is used more in women. Procedural complications for the management of AF are higher in women.

Summary

The study of the pathophysiology of AF and its management is a rapidly evolving area of cardiovascular medicine. Sex-specific data is necessary to achieve advances in the field and improve the outcomes in both men and women.

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Authors and Affiliations

  1. Rush Heart Center for Women, 1725 W. Harrison St. Suite 1159, Chicago, IL, 60612-3864, USA

    Charlotte J. Bai MD & Annabelle Santos Volgman MD

  2. Rush University Medical Center, 1717 W. Congress Pkwy, Suite 317 Kellogg, Chicago, IL, 606012, USA

    Nidhi Madan MD

  3. King Abdul-Aziz University, Jeddah, Saudi Arabia

    Shaza Alshahrani MBBS

  4. Rush Alzheimer’s Disease Center, Rush Heart Center for Women, 1725 Harrison St. Suite 1159, Chicago, IL, 60612, USA

    Neelum T. Aggarwal MD

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  1. Charlotte J. Bai MD
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  3. Shaza Alshahrani MBBS
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  4. Neelum T. Aggarwal MD
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  5. Annabelle Santos Volgman MD
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Correspondence to Charlotte J. Bai MD.

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Charlotte Bai, Nidhi Madan, Shaza Alshahrani, and Annabelle Santos Volgman each declare no potential conflicts of interest.

Neelum T. Aggarwal declares the following: Merck and Company-Adjudication Committee member (Consultant); Eli Lilly: Clinical Trial of Solanezumab for Older Individuals Who May be at Risk for Memory Loss (A4 Study-Site Principal Investigator-Rush) ClinicalTrials.gov Identifier: NCT02008357; Novartis/AMGEN: A Study of CAD106 and CNP520 Versus Placebo in Participants at Risk for the Onset of Clinical Symptoms of Alzheimer’s Disease (Generation S1)-Site Principal Investigator-Rush: ClinicalTrials.gov Identifier: NCT02565511; Novartis/AMGEN: A Study of CNP520 Versus Placebo in Participants at Risk for the Onset of Clinical Symptoms of Alzheimer’s Disease (Generation S2)- Site Principal Investigator- Rush ClinicalTrials.gov Identifier: NCT03131453; and Janssen: An Efficacy and Safety Study of JNJ-54861911 in Participants Who Are Asymptomatic at Risk for Developing Alzheimer’s Dementia (EARLY)-Site Principal Investigator-Rush ClinicalTrials.gov Identifier: NCT02569398.

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Bai, C.J., Madan, N., Alshahrani, S. et al. Sex Differences in Atrial Fibrillation—Update on Risk Assessment, Treatment, and Long-Term Risk. Curr Treat Options Cardio Med 20, 79 (2018). https://doi.org/10.1007/s11936-018-0682-3

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