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Sex-related differences in risk factors, type of treatment received and outcomes in patients with atrial fibrillation and acute stroke: Results from the RAF-study (Early Recurrence and Cerebral Bleeding in Patients with Acute Ischemic Stroke and Atrial Fibrillation)

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Author(s)
Kateryna AntonenkoMaurizio PaciaroniGiancarlo AgnelliNicola FalocciCecilia BecattiniSimona MarcheselliChristina RueckertAlessandro PezziniLoris PoliAlessandro PadovaniLaszlo´ CsibaLilla Szabo´Sung-Il SohnTiziana TassinariAzmil H Abdul-RahimPatrik MichelMaria CordierPeter VanackerSuzette RemillardAndrea AlbertiMichele VentiMonica AcciarresiCataldo D’AmoreUmberto ScodittiLicia DentiGiovanni OrlandiAlberto ChitiGino GialdiniPaolo BoviMonica CarlettiAlberto RigatelliJukka PutaalaTurgut TatlisumakLuca MasottiGianni LorenziniRossana TassiFrancesca GuideriGiuseppe MartiniGeorgios TsivgoulisKostantinos VadikoliasSokratis G PapageorgiouFrancesco CoreaMassimo Del SetteWalter AgenoMaria Luisa De LodoviciGiorgio BonoAntonio BaldiSebastiano D’AnnaSimona SaccoAntonio CaroleiCindy TiseoDavide ImbertiDorjan ZabzuniBoris DoroninVera VolodinaDomenico ConsoliFranco GalatiAlessio PieroniDanilo ToniSerena MonacoMario M BaronelloKristian BarlinnLars-Peder PallesenJessica KepplingerUlf BodechtelJohannes GerberDirk DeleuGayane MelikyanFaisal IbrahimNaveed AkhtarMaria G MosconiKennedy R LeesValeria Caso
Keimyung Author(s)
Sohn, Sung Il
Department
Dept. of Neurology (신경과학)
Journal Title
European Stroke Journal
Issued Date
2017
Volume
2
Issue
1
Keyword
Sex differencesatrial fibrillationischemic strokesecondary preventionanticoagulation therapystroke outcome
Abstract
Introduction: Atrial fibrillation is an independent risk factor of thromboembolism. Women with atrial fibrillation are at
a higher overall risk for stroke compared to men with atrial fibrillation. The aim of this study was to evaluate for sex
differences in patients with acute stroke and atrial fibrillation, regarding risk factors, treatments received and outcomes.
Methods: Data were analyzed from the ‘‘Recurrence and Cerebral Bleeding in Patients with Acute Ischemic Stroke and
Atrial Fibrillation’’ (RAF-study), a prospective, multicenter, international study including only patients with acute stroke
and atrial fibrillation. Patients were followed up for 90 days. Disability was measured by the modified Rankin Scale (0–2
favorable outcome, 3–6 unfavorable outcome).
Results: Of the 1029 patients enrolled, 561 were women (54.5%) (p<0.001) and younger (p<0.001) compared to
men. In patients with known atrial fibrillation, women were less likely to receive oral anticoagulants before index stroke
(p¼0.026) and were less likely to receive anticoagulants after stroke (71.3% versus 78.4%, p¼0.01). There was no
observed sex difference regarding the time of starting anticoagulant therapy between the two groups (6.4 11.7 days for
men versus 6.5 12.4 days for women, p¼0.902). Men presented with more severe strokes at onset (mean NIHSS
9.2 6.9 versus 8.1 7.5, p<0.001). Within 90 days, 46 (8.2%) recurrent ischemic events (stroke/TIA/systemic embolism)
and 19 (3.4%) symptomatic cerebral bleedings were found in women compared to 30 (6.4%) and 18 (3.8%) in men
(p¼0.28 and p¼0.74). At 90 days, 57.7% of women were disabled or deceased, compared to 41.1% of the men
(p<0.001). Multivariate analysis did not confirm this significance.
Conclusions: Women with atrial fibrillation were less likely to receive oral anticoagulants prior to and after stroke
compared to men with atrial fibrillation, and when stroke occurred, regardless of the fact that in our study women were
younger and with less severe stroke, outcomes did not differ between the sexes.
Keimyung Author(s)(Kor)
손성일
Publisher
School of Medicine
Citation
Kateryna Antonenko et al. (2017). Sex-related differences in risk factors, type of treatment received and outcomes in patients with atrial fibrillation and acute stroke: Results from the RAF-study (Early Recurrence and Cerebral Bleeding in Patients with Acute Ischemic Stroke and Atrial Fibrillation). European Stroke Journal, 2(1), 46–53. doi: 10.1177/2396987316679577
Type
Article
ISSN
2396-9873
Source
http://journals.sagepub.com/doi/10.1177/2396987316679577
DOI
10.1177/2396987316679577
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/32756
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Neurology (신경과학)
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