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Sex difference in clinical outcomes of Chinese patients with atrial fibrillation and coronary stenting according to age [Anatol J Cardiol]
Anatol J Cardiol. Ahead of Print: AJC-80930 | DOI: 10.14744/AnatolJCardiol.2020.80930  

Sex difference in clinical outcomes of Chinese patients with atrial fibrillation and coronary stenting according to age

Jian-Yong Zheng1, Dong-Tao Li1, Yu Chen1, Yi-Da Tang2, Cheng-Jun Guo3, Yun-Dai Chen4, Zhi-Min Ma5, Tian-Chang Li1
1Department of Cardiology, Sixth Medical Center of PLA General Hospital, Beijing, China
2Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China
3Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
4Department of Cardiology, First Medical Center of PLA General Hospital, Beijing, China
5Department of Cardiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China

Objective: Sex differences in the clinical outcomes of patients with atrial fibrillation (AF) and coronary stenting should be assessed according to age.
Methods: We analyzed the clinical data of all patients with nonvalvular AF who underwent coronary stenting between January 2010 and June 2015 in 12 hospitals of Beijing, China.
Results: A total of 2,146 patients (71.8% men and 28.2% women) were included with a mean age of 66.69.4 years. Women were older and had higher prevalence of hypertension, diabetes, chronic kidney disease (CKD) and anemia, but were less likely to be current smokers compared to men. The mean follow-up duration was 39.7 months. As for patients younger than 65 years, women had a remarkably higher mortality (11.2% vs. 5.3%, P=0.012) and a significantly lower rate of repeat revascularization (1.6% vs. 6.3%, P=0.034) than men. After multiple variate regression, female gender remained an independent predictor for all-cause mortality (hazard ratio [HR]=2.03, 95% confidence interval [CI]: 1.09-3.79, P=0.025), along with heart failure (HR=3.64, 95% CI: 2.02-6.57, P<0.001) and CKD (HR=2.46, 95% CI: 1.09-5.57, P=0.031). In elderly patients, no significant difference was noted between men and women with regard to mortality, ischemic events and major bleeding.
Conclusion: In Chinese patients younger than 65 years with AF and coronary stenting, female gender was independently associated with increased mortality; men were more likely to receive repeat revascularization possibly promoted by ongoing smoking. Whether it was a biological difference or a recognition disparity of the disease between men and women warrants further investigation.

Keywords: Sex, Age, Atrial fibrillation, Percutaneous coronary intervention, Mortality




Corresponding Author: Tian-Chang Li, China


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