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Sex Differences in Disease Profiles, Management, and Outcomes Among People with Atrial Fibrillation After Ischemic Stroke: Aggregated and Individual Participant Data Meta-Analyses.
Wang, Xia; Phan, Hoang T; Li, Jingwei; Reeves, Mathew J; Thrift, Amanda G; Cadilhac, Dominique A; Sturm, Jonathan; Konstantinos, Vemmos; Parmar, Priya; Krishnamurthi, Rita; Barker-Collo, Suzanne; Feigin, Valery; Cabral, Norberto L; Carolei, Antonio; Marini, Carmine; Sacco, Simona; Correia, Manuel; Appelros, Peter; Kõrv, Janika; Vibo, Riina; Yang, Sook Ching; Carcel, Cheryl; Woodward, Mark; Sandset, Else Charlotte; Anderson, Craig; Gall, Seana.
Afiliación
  • Wang X; The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, Australia.
  • Phan HT; Menzies Institute for Medical Research Tasmania, University of Tasmania, Hobart, Australia.
  • Li J; Department of Health Management and Health Economics, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam.
  • Reeves MJ; Department of Cardiology, People's Liberation Army General Hospital, Beijing, China.
  • Thrift AG; Department of Cardiology, Xinqiao Hospital, Army Military Medical University, Chongqing, China.
  • Cadilhac DA; Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, Michigan, USA.
  • Sturm J; Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia.
  • Konstantinos V; Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia.
  • Parmar P; Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia.
  • Krishnamurthi R; Department of Clinical Therapeutics, Alexandra Hospital, National and Kapodistrian University of Athens, Athens, Greece.
  • Barker-Collo S; National Institute for Stroke and Applied Neurosciences, School of Public Health and Psychosocial Studies, Auckland University of Technology, Auckland, New Zealand.
  • Feigin V; National Institute for Stroke and Applied Neurosciences, School of Public Health and Psychosocial Studies, Auckland University of Technology, Auckland, New Zealand.
  • Cabral NL; School of Psychology, University of Auckland, Auckland, New Zealand.
  • Carolei A; School of Psychology, University of Auckland, Auckland, New Zealand.
  • Marini C; Clinica Neurológica de Joinville, Joinville Stroke Registry, University of Joinville Region-Univille, Joinville, Brazil.
  • Sacco S; Department of Biotechnological and Applied Clinical Sciences, Neurological Institute, University of L'Aquila, Italy.
  • Correia M; Department of Life, Health, and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.
  • Appelros P; Department of Biotechnological and Applied Clinical Sciences, Neurological Institute, University of L'Aquila, Italy.
  • Kõrv J; InstitutodeCiênciasBiomédicasdeAbelSalazar, UniversidadedoPorto, Porto, Portugal.
  • Vibo R; Department of Neurology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
  • Yang SC; Department of Neurology and Neurosurgery, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia.
  • Carcel C; Department of Neurology and Neurosurgery, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia.
  • Woodward M; Department of Cardiology, The Royal Infirmary of Edinburgh, Edinburgh, United Kingdom.
  • Sandset EC; The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, Australia.
  • Anderson C; Department of Neurology, Royal Prince Alfred Hospital, the University of Sydney, Sydney, Australia.
  • Gall S; The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, Australia.
Womens Health Rep (New Rochelle) ; 1(1): 190-202, 2020.
Article en En | MEDLINE | ID: mdl-33786481
Objectives: To examine sex differences in disease profiles, management, and survival at 1 and 5 years after ischemic stroke (IS) among people with atrial fibrillation (AF). Methods: We performed a systematic literature search of reports of AF at IS onset according to sex. We undertook an individual participant data meta-analysis (IPDMA) of nine population-based stroke incidence studies conducted in Australasia, Europe, and South America (1993-2014). Poisson regression was used to estimate women:men mortality rate ratios (MRRs). Study-specific MRRs were combined using random effects meta-analysis. Results: In our meta-analysis based on aggregated data from 101 studies, the pooled AF prevalence was 23% (95% confidence interval [CI]: 22%-25%) in women and 17% (15%-18%) in men. Our IPDMA is of 1,862 IS-AF cases, with women (79.2 ± 9.1, years) being older than men (76.5 ± 9.5, years). Crude pooled mortality rate was greater for women than for men (1-year MRR 1.24; 1.01-1.51; 5-year 1.12; 1.03-1.22). However, the sex difference was greatly attenuated after accounting for age, prestroke function, and stroke severity (1-year 1.09; 0.97-1.22; 5-year 0.98; 0.84-1.16). Women were less likely to have anticoagulant prescription at discharge (odds ratio [OR] 0.94; 95% CI: 0.89-0.98) than men when pooling IPDMA and aggregated data. Conclusions: AF was more prevalent after IS among women than among men. Among IS-AF cases, women were less likely to receive anticoagulant agents at discharge; however, greater mortality rate in women was mostly attributable to prestroke factors. Further information needs to be collected in population-based studies to understand the reasons for lower treatment of AF in women.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Incidence_studies / Risk_factors_studies / Systematic_reviews Idioma: En Revista: Womens Health Rep (New Rochelle) Año: 2020 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Incidence_studies / Risk_factors_studies / Systematic_reviews Idioma: En Revista: Womens Health Rep (New Rochelle) Año: 2020 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Estados Unidos