![]() ![]() ![]() 6 The study and all its analyses are approved under a continuous institutional review board at Duke University (the coordinating center) and each participating center obtained local institutional review board approval all participants provided informed consent. The rationale, design, and methods of the ORBIT-AF registry have been reported previously. Patients were enrolled at 176 sites between June 2010 and August 2011 by a diverse group of health care professionals including internists, cardiologists, and electrophysiologists. The ORBIT-AF study is a prospective, multicenter nationwide, outpatient registry of patients with incident and prevalent AF. We hypothesized that women with AF would have worse symptoms, lower QoL, and worse clinical outcomes relative to men. Accordingly, we examined whether symptoms, functional capacity, and QoL differed between women and men enrolled in ORBIT-AF. The nationwide multicenter Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF) provides a unique opportunity to examine this gap in knowledge because the registry prospectively collects information on AF treatment and patients’ health status. 3 - 5 If present, such sex-related differences could stimulate new efforts to better manage AF, potentially including antiarrhythmic therapy and radiofrequency ablation, to minimize health status disparities. 1, 2 While there are well-documented sex-based differences in treatment, health status, and other clinical outcomes in other cardiovascular diseases, these have been infrequently described in AF. Trial Registration Identifier: NCT01165710Ītrial fibrillation (AF) is a growing and costly public health problem for which most studies have focused on thromboembolic outcomes, although the disease is known to impair patients’ health status: their symptoms, function, and quality of life (QoL). Future studies should focus on how treatment and interventions specifically affect AF-related quality of life and cardiovascular outcomes in women. ![]() Despite higher risk, women have lower risk-adjusted all-cause and cardiovascular death compared with men, but higher stroke rates. In follow-up, women experienced lower risk-adjusted all-cause mortality (adjusted hazard ratio, 0.57 95% CI, 0.49-0.67) and cardiovascular death (adjusted hazard ratio, 0.56 95% CI, 0.44-0.72) however, they had a higher risk for stroke or non–central nervous system embolism (adjusted hazard ratio, 1.39 95% CI, 1.05-1.84 P = .02) compared with men.Ĭonclusions and Relevance Women with AF have more symptoms and worse quality of life. Women had similar rates of anticoagulation and similar time in therapeutic range. ![]() Women had lower (more severe) unadjusted baseline overall Atrial Fibrillation Effects on Quality of Life scores (n = 2007 80 IQR, 62-92 vs 83 IQR, 69-94 P < .001). Only 32.1% of women (n = 1378) were asymptomatic (European Heart Rhythm Association class I) compared with 42.5% of men (n = 2483) in unadjusted analyses ( P < .001). Compared with men, women were older (77 years interquartile range, 69-83, vs 73 years IQR, 65-80 P < .001) and had higher median CHA 2DS 2-VASc scores (5 IQR, 4-6, vs 3 IQR, 2-5 P < .001), but less sleep apnea (578 vs 1264 P < .001). Results Overall, 4293 of the cohort (42%) were female. Main Outcomes and Measures Symptoms, quality of life as measured by Atrial Fibrillation Effects on Quality of Life scores, AF treatment, cardiovascular outcomes, stroke or non–central nervous system embolism, and all-cause mortality. The Outcomes Registry for Better Informed Treatment of Atrial Fibrillation is a prospective, nationwide, multicenter outpatient registry of patients with incident and prevalent AF enrolled at 176 sites between June 2010 and August 2011. Objective To determine whether symptoms, quality of life, treatment, and outcomes differ between women and men with AF.ĭesign, Setting, and Participants This observational cohort study included 10 135 patients with AF. Importance Despite the frequency of atrial fibrillation (AF) in clinical practice, relatively little is known about sex differences in symptoms and quality of life and how they may affect treatment and outcomes.
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