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Gender differences in stroke risk of atrial fibrillation patients on oral anticoagulant treatment

Poli, Daniela ; Antonucci, Emilia ; Grifoni, Elisa ; Abbate, Rosanna ; Gensini, Gian Franco ; Prisco, Domenico

Thrombosis and haemostasis, 2009-05, Vol.101 (5), p.938-942 [Periódico revisado por pares]

Stuttgart: Schattauer Verlag für Medizin und Naturwissenschaften

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Título:
Gender differences in stroke risk of atrial fibrillation patients on oral anticoagulant treatment
Autor: Poli, Daniela ; Antonucci, Emilia ; Grifoni, Elisa ; Abbate, Rosanna ; Gensini, Gian Franco ; Prisco, Domenico
Assuntos: Administration, Oral ; Adult ; Aged ; Aged, 80 and over ; Anticoagulants - administration & dosage ; Anticoagulants - adverse effects ; Atrial fibrillation ; Atrial Fibrillation - complications ; Atrial Fibrillation - drug therapy ; Atrial Fibrillation - mortality ; Biological and medical sciences ; Blood coagulation. Blood cells ; Brain Ischemia - etiology ; Brain Ischemia - mortality ; Brain Ischemia - prevention & control ; Cardiovascular Biology and Cell Signalling ; Female ; female gender ; Fundamental and applied biological sciences. Psychology ; Healthcare Disparities ; Hematologic and hematopoietic diseases ; Hemorrhage - chemically induced ; Hemorrhage - mortality ; Humans ; Male ; Medical sciences ; Middle Aged ; Molecular and cellular biology ; Platelet diseases and coagulopathies ; Proportional Hazards Models ; Prospective Studies ; quality of anticoagulation ; Quality of Health Care ; Risk Assessment ; Risk Factors ; Sex Factors ; Stroke ; Stroke - etiology ; Stroke - mortality ; Stroke - prevention & control ; Time Factors ; Treatment Outcome ; warfarin ; Warfarin - administration & dosage ; Warfarin - adverse effects ; Women's Health
É parte de: Thrombosis and haemostasis, 2009-05, Vol.101 (5), p.938-942
Descrição: Summary The efficacy of adjusted-dose oral anticoagulant treatment (OAT) in the prevention of stroke in atrial fibrillation (AF) is well documented. Available data show that AF patients are widely heterogeneous in terms of ischaemic stroke risk. The role of female gender as a predictor of stroke risk is inconsistent, in particular it is unclear if warfarin treatment is able to prevent stroke equally in both sexes. We performed a prospective study on 780 AF patients on OAT, followed by an Anticoagulation Clinic, to evaluate if female gender is a risk factor for stroke among patients on OAT and if the quality of anticoagulation is different between genders. No difference was found in relation to the quality of anticoagulation between genders (p=0.5). During follow-up 33 patients had major bleedings (rate 1.37x100 pt/yrs) but no difference was found between genders in bleeding risk. Forty patients had ischaemic events [rate 1.66x100 pt/yrs; males rate 1.2 x100 pt/yrs; females rate 2.43x100 pt/yrs; p=0.042; relative risk (RR) of females vs. males 2.0 (95% confidence interval [CI] 1.3–3.1); p= 0.004]. The higher rate of ischaemic events in females with respect to males was confirmed at Cox regression analysis after correction for age (p=0.009). In addition, strokes occurring in females were more disabling, and RR for severe and fatal stroke, defined according to Modified Rankin scale, of females vs. males was 3.1 (95% CI 1.3–6.5; p=0.001). In conclusion, our data show a higher risk of stroke in anticoagulated AF females with respect to males, despite a similar quality of anticoagulation.
Editor: Stuttgart: Schattauer Verlag für Medizin und Naturwissenschaften
Idioma: Inglês

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Gender differences in stroke risk of atrial fibrillation patients on oral anticoagulant treatment

Poli, Daniela ; Antonucci, Emilia ; Grifoni, Elisa ; Abbate, Rosanna ; Gensini, Gian Franco ; Prisco, Domenico

Stuttgart: Schattauer Verlag für Medizin und Naturwissenschaften

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