Impact of gender on event rates at 1 year in patients with newly diagnosed non-valvular atrial fibrillation: contemporary perspective from the GARFIELD-AF registry

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00064203%3A_____%2F17%3A10373845" target="_blank" >RIV/00064203:_____/17:10373845 - isvavai.cz</a>

Výsledek na webu

<a href="https://doi.org/10.1136/bmjopen-2016-014579" target="_blank" >https://doi.org/10.1136/bmjopen-2016-014579</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1136/bmjopen-2016-014579" target="_blank" >10.1136/bmjopen-2016-014579</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Impact of gender on event rates at 1 year in patients with newly diagnosed non-valvular atrial fibrillation: contemporary perspective from the GARFIELD-AF registry

Popis výsledku v původním jazyce

Objectives: Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) explored the impact of gender, risk factors and anticoagulant (AC) treatment on 1-year outcomes in patients with nonvalvular atrial fibrillation (NVAF). Design: GARFIELD-AF is a prospective noninterventional registry. Setting: Investigator sites (n= 1048) are representative of the care settings/ locations in each of the 35 countries. Participants: Patients &gt;= 18yrs with newly diagnosed (&lt;= 6 weeks&apos; duration) NVAF and &gt;= 1 investigatordetermined stroke risk factors. Main outcome measures: Event rates per 100 person-years were estimated from the Poisson model and HRs and 95% CIs calculated. Results: Of 28 624 patients (women 44.4%; men 55.6%) enrolled, there were more elderly (&gt;= 75 years) women (46.9%) than men(30.4%).All-cause mortality rates per 100 person-years (95% CI) for women and men were 4.48 (4.12 to 4.87) and 4.04 (3.74 to 4.38), respectively, stroke/ systemic embolism (SE) (1.62 (1.41 to 1.87) and 1.17 (1.01 to 1.36)) and major bleeding (0.93 (0.78 to 1.13) and 0.79 (0.66 to 0.95)). After adjustment for baseline risk factors in treated and untreated patients, HRs (95% CI) for women (relative to men) for stroke/ SE rates were 1.3-fold higher in women (HR 1.30 (1.04 to 1.63)), and similar for major bleeding (1.13 (0.85 to 1.50)) and all-cause mortality (1.05 (0.92 to 1.19)). Antithrombotic treatment patterns in men and women were almost identical. 63.8% women and 62.9% men received AC +/- antiplatelets. Relative to no AC treatment, the reduction in stroke/ SE rates with AC treatment was greater (p= 0.01) in men (HR 0.45 (0.33 to 0.61)) than women 0.77 (0.57 to 1.03). All-cause mortality reduction with AC treatment was similar (women: 0.65 (0.54 to 0.77); men: 0.57 (0.48 to 0.68)). The risk of major bleeding when treated with AC versus no AC was 2.33 (1.41 to 3.84) in men and 1.86 (1.16 to 2.99) in women (p value= 0.53). Conclusions: Women have a higher risk of stroke/SE and the reduction in stroke/ SE events rates with AC treatment is less in women than in men.

Název v anglickém jazyce

Impact of gender on event rates at 1 year in patients with newly diagnosed non-valvular atrial fibrillation: contemporary perspective from the GARFIELD-AF registry

Popis výsledku anglicky

Objectives: Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) explored the impact of gender, risk factors and anticoagulant (AC) treatment on 1-year outcomes in patients with nonvalvular atrial fibrillation (NVAF). Design: GARFIELD-AF is a prospective noninterventional registry. Setting: Investigator sites (n= 1048) are representative of the care settings/ locations in each of the 35 countries. Participants: Patients &gt;= 18yrs with newly diagnosed (&lt;= 6 weeks&apos; duration) NVAF and &gt;= 1 investigatordetermined stroke risk factors. Main outcome measures: Event rates per 100 person-years were estimated from the Poisson model and HRs and 95% CIs calculated. Results: Of 28 624 patients (women 44.4%; men 55.6%) enrolled, there were more elderly (&gt;= 75 years) women (46.9%) than men(30.4%).All-cause mortality rates per 100 person-years (95% CI) for women and men were 4.48 (4.12 to 4.87) and 4.04 (3.74 to 4.38), respectively, stroke/ systemic embolism (SE) (1.62 (1.41 to 1.87) and 1.17 (1.01 to 1.36)) and major bleeding (0.93 (0.78 to 1.13) and 0.79 (0.66 to 0.95)). After adjustment for baseline risk factors in treated and untreated patients, HRs (95% CI) for women (relative to men) for stroke/ SE rates were 1.3-fold higher in women (HR 1.30 (1.04 to 1.63)), and similar for major bleeding (1.13 (0.85 to 1.50)) and all-cause mortality (1.05 (0.92 to 1.19)). Antithrombotic treatment patterns in men and women were almost identical. 63.8% women and 62.9% men received AC +/- antiplatelets. Relative to no AC treatment, the reduction in stroke/ SE rates with AC treatment was greater (p= 0.01) in men (HR 0.45 (0.33 to 0.61)) than women 0.77 (0.57 to 1.03). All-cause mortality reduction with AC treatment was similar (women: 0.65 (0.54 to 0.77); men: 0.57 (0.48 to 0.68)). The risk of major bleeding when treated with AC versus no AC was 2.33 (1.41 to 3.84) in men and 1.86 (1.16 to 2.99) in women (p value= 0.53). Conclusions: Women have a higher risk of stroke/SE and the reduction in stroke/ SE events rates with AC treatment is less in women than in men.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30201 - Cardiac and Cardiovascular systems

Projekt

—

Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2017

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

BMJ Open [online]

ISSN

2044-6055

e-ISSN

—

Svazek periodika

7

Číslo periodika v rámci svazku

3

Stát vydavatele periodika

GB - Spojené království Velké Británie a Severního Irska

Počet stran výsledku

10

Strana od-do

—

Kód UT WoS článku

000398959400165

EID výsledku v databázi Scopus

2-s2.0-85014587482