Author + information
- Laurent Fauchier,
- Arnaud Bisson,
- Denis Angoulvant,
- Nicolas Clementy,
- Dominique Babuty and
- Gregory Lip
Background: CHA2DS2-VASc scores is a tool estimating the risk of stroke in patients with atrial fibrillation (AF). CHA2DS2-VASc score is also able to identify patients at higher risk of AF following ischemic strokes (IS) among patients without known AF. We compared gender-related differences in items from CHA2DS2-VASc score and their relationship with possible AF occurrence dissimilarities in men and women after IS.
Methods: This French longitudinal cohort study was based on the national database covering hospital care from 2009 to 2012 for the entire population.
Results: Of 336,291 patients with IS from 2009 to 2012, 240,459 (71.5%) did not have AF at baseline. A total of 14,095 (5.9%) of these patients were diagnosed as having AF during a follow-up of 7.9±11.5 months (incidence rate 8.9 per 100 person-years, 50.3% female, 49.7% male). The total incidence of AF was superior in women (9.8%) than in men (8.2%). In patients with IS without pre-existing AF at baseline, increasing CHA2DS2-VASc score was associated with the risk of new onset (or previously undiagnosed) AF during follow-up (overall HR 1.43 CI 1.41-1.45, HR 1.48 CI 1.45-1.50 in men and HR 1.46 CI 1.44-1.49 in women). In the total population, predictors of incident AF were older age, hypertension, heart failure, non-cerebral systemic embolism and vascular/coronary artery disease. Results were similar when one analysed separately these predictors for men and women except for peripheral/vascular disease (NS) and non-cerebral systemic embolism (NS) in men. Diagnostic values of the CHA2DS2-VASc score for identifying patients at higher risk of incident AF were similar between men (C statistics 0.720, 95%CI 0.717-0.722) and women (C statistics 0.702, 95%CI 0.699-0.704).
Conclusions: Whilst there are significant differences in comorbidities and possible mechanisms of AF in men and women, a strategy using CHA2DS2-VASc score for identifying a higher risk of incident (or previously unknown) AF might be similarly proposed in both genders because most results were similar in both groups and because sex ratio of new AF after stroke was close to 1.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Fibrillatory Arrhythmias: Outcomes With Contemporary Practice
Abstract Category: 8. Arrhythmias and Clinical EP: Supraventricular/Ventricular Arrhythmias
Presentation Number: 1110-102
- 2017 American College of Cardiology Foundation