Arrhythmias and Conduction DisturbancesMeta-Analysis of Gender Differences in Residual Stroke Risk and Major Bleeding in Patients With Nonvalvular Atrial Fibrillation Treated With Oral Anticoagulants
Section snippets
Methods
Using the keywords “atrial Fibrillation,” “gender,” “anti-coagulation,” and “outcomes,” we searched indexed studies recorded in major databases including PubMed, EMBASE, Cochrane Library, and Google Scholar. The method outlined in the Preferred Reporting Items for Systemic Reviews and Meta-analysis document was used.14 A total of 452 relevant studies were identified on search using these databases and reviewed independently by 4 investigators to check if they met inclusion criteria. We included
Results
A total of 6 studies met inclusion criteria.15, 16, 17, 18, 19, 20 Baseline characteristics of patients from the included trials are listed in Table 1.
Five studies15, 16, 17, 18, 19 reporting gender-specific annualized event rates of CVA/SE in patients with AF treated with warfarin prophylaxis were included in the first analysis. The pooled sample consisted of 26,260 patients, with 16,760 men and 9,500 women. A total of 478 men (2.85%) and 349 women (3.67%) developed CVA/SE. The forest plot
Discussion
The results of our meta-analysis indicate that women with AF have a significantly greater residual risk of CVA/SE when treated using warfarin prophylaxis compared with men. The gender difference disappears when a similar analysis is performed on a pooled population treated with NOACs found to be superior to warfarin, in published randomized trials. Coincidentally, these NOACs found superior to warfarin are the agents approved by Food and Drug Administration for use in the United States.
Gender
Disclosures
The authors have no conflicts of interest to disclose.
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2022, Canadian Journal of Cardiology
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