Abstract 12091: Higher Chadsvasc Scores but Similar Complication and Mortality Rates in Women With Atrial Fibrillation Over 1 Year in an Outpatient Cardiology Setting
Background: Gender differences in atrial fibrillation are recognized with women having a higher stroke risk and therefore having an extra point attributed within the CHADSVasc score. We evaluate if a higher score affects oral anticoagulant use (OAC) and outcomes over 1 year.
Methods: Retrospective chart review of all pts being treated for atrial fibrillation in a single, multi-site suburban, outpatient cardiology practice for the calendar year 2014.
Results: Of the 1366 pts being followed 645 (47.2%) were females. Females had a higher CHADSVasc score (4.0± 1.6 vs 2.7± 1.6, p=0.001). This difference was driven by the CHADSVasc components of age > 75 (47% vs 31%, p=0.001) and cerebrovascular accidents (16% vs 12.5%, p=0.05). Other components were similar-heart failure (26 vs 26%), hypertension (82 vs 81%), diabetes (31 vs 31%) vascular disease (12 vs 13%). The % of females vs males having a CHADSVasc score of 1-3 was (32 vs 68%, p<0.00001) 4-6 (66 vs 34%, p<0.00001) and 7-9 (80 vs 20%, p=0.000001). Females had a higher ejection fraction (56 vs 53%, p=0.6) and more valvular heart disease (32 vs 24%, p=0.0002) but similar BMI (29 vs 29). Paroxysmal AF was similar (72% vs 70%) Females were more likely to have Medicare coverage vs private insurance (64% vs 29%, p=0.000054) and more often of black ethnicity (35 vs 23%, p=0.000001). Females were equally likely to be prescribed warfarin vs a NOAC (48 vs 45.1%, p=0.3) and time in therapeutic range was similar at 50%. There was no difference in the number of pts not receiving an OAC (49.7 vs 50.3%, p=0.3) Stroke and bleeding complication rates over 1 year were similar (9.1% vs 8.5%, p=0.6) as was mortality (3.7 vs 3.9%, p=0.8).
Conclusions: Our findings confirm that women with atrial fibrillation tend to be older which results in a higher CHADSVasc score. This however did not appear to translate into a higher utilization of OAC compared to men but also did not worsen 1 year outcomes. If validated in other datasets then it may be necessary to revisit if females warrant an extra point on the CHADSVasc scale in the contemporary AF population.
Author Disclosures: T. Foltz: None. N. Singh: Honoraria; Significant; JANSSEN, BOEHRINGER INGELHEIM, DAIICHI-SANKYO, BRISTOL-MYERS SQUIBB. S. Chandra: None. D. Song: None. L. Yan: None. D. Suh: None.
- © 2016 by American Heart Association, Inc.