To examine sex differences in thromboprophylaxis in patients with atrial fibrillation
before and after the introduction of non–vitamin K oral anticoagulants, we performed
a cross-sectional registry study based on anonymized individual-level patient data
of all individuals with a diagnosis of nonvalvular atrial fibrillation (International
Classification of Diseases, Tenth Revision code I48) in the region of Stockholm, Sweden
(2.2 million inhabitants), in 2011 and 2015, respectively. Thromboprophylaxis improved
considerably during the period. During 2007 to 2011, 23,198 men and 18,504 women had
an atrial fibrillation diagnosis. In 2011, more men than women (53% men vs 48% women)
received oral anticoagulants (almost exclusively warfarin) and more women received
aspirin only (35% women vs 30% men), whereas there was no sex difference for no thromboprophylaxis
(17%). During 2011 to 2015, 27,237 men and 20,461 women had a diagnosis of atrial
fibrillation. Compared with the earlier time period, a higher proportion used oral
anticoagulants (71% women vs 70% men), but fewer women ≥80 years received anticoagulants
(67% women vs 72% men), more women received aspirin (15% women vs 13% men), and fewer
women had no thromboprophylaxis (15% women vs 17% men). Patients with co-morbidities
potentially complicating oral anticoagulant use used more oral anticoagulant in 2015
compared with 2011. The sex differences observed in 2011 with fewer women using oral
anticoagulants had disappeared in 2015 except in women 80 years and older and in patients
with complicated co-morbidity.
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Article Info
Publication History
Published online: July 21, 2017
Accepted:
July 12,
2017
Received:
April 18,
2017
Footnotes
See page 1306 for disclosure information.
Funding: The study was supported by the Stockholm County Council (ALF project grant number LS 2015-0630 ), the Erika Lederhausen foundation , Center for Gender Medicine , Karolinska Institutet , the Swedish Association of Local Authorities and Regions (SALAR, SKL 08/2254 ), and by the Swedish Heart-Lung Foundation .
Location: Stockholm, Sweden.
Identification
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