Sex differences in atrial fibrillation in India: Insights from the Kerala-AF registry

Calvert, P, Chen, Y, Gue, Y, Gupta, D, Azariah, JL, George Koshy, A, Zachariah, G, Natarajan, KU, Lip, GYH ORCID: 0000-0002-7566-1626, Gopalan, BC, Namboodiri, N, Jabir, A, George Koshy, A, Shifas Babu, M, Venugopal, K, Punnose, E, Natarajan, KU, Joseph, J, Ashokan Nambiar, C, Jayagopal, PB et al (2024) Sex differences in atrial fibrillation in India: Insights from the Kerala-AF registry. Journal of Arrhythmia. ISSN 1880-4276

Preview

Text Sex differences in atrial fibrillation in India Insights from the.pdf - Published Version Available under License Creative Commons Attribution. Download (498kB) | Preview

Abstract

Background: Much data informing sex differences in atrial fibrillation (AF) comes from Western cohorts. In this analysis, we describe sex differences in Kerala, India, using the Kerala-AF registry—the largest AF registry from the Indian subcontinent. Methods: Patients aged ≥18 years were recruited from 53 hospitals across Kerala. Patients were compared for demographics, treatments, and 12-month outcomes, including major adverse cardiovascular events (MACE) and bleeding. Results: Male patients were more likely to have a smoking and/or alcohol history and had more ischaemic heart disease (46.2% vs. 25.5%; p < 0.001). Female patients had more valvular AF (35.1% vs. 18.0%; p < 0.001), and more use of calcium-channel blockers (23.3% vs. 16.5%; p < 0.001) or digoxin (39.6% vs. 28.5%; p < 0.001). Almost one in four patients were not anticoagulated despite raised CHA2DS2-VASc scores. 12-month MACE outcomes did not differ by sex (male: 30.2% vs. female: 29.4%; p = 0.685), though bleeding events were more common in male patients (2.4% vs. 1.3%; p = −0.038), driven by minor bleeding (1.2% vs. 0.5%). Conclusion: In this large AF cohort from India, male patients had a higher prevalence of ischaemic heart disease, smoking, and alcohol use, while female patients had a higher prevalence of valvular heart disease. MACE did not differ by sex, though bleeding was more common in males. Almost a quarter of patients were not anticoagulated despite raised thromboembolic risk.

Item Type:	Article
Uncontrolled Keywords:	Heart Disease; Alcoholism, Alcohol Use and Health; Cardiovascular; Substance Misuse; 4.2 Evaluation of markers and technologies; Cardiovascular; 3 Good Health and Well Being
Subjects:	Q Science > QH Natural history > QH301 Biology R Medicine > R Medicine (General)
Divisions:	Education Nursing and Advanced Practice
Publisher:	Wiley
Date of acceptance:	21 November 2024
Date of first compliant Open Access:	20 December 2024
Date Deposited:	20 Dec 2024 10:57
Last Modified:	03 Jul 2025 16:45
DOI or ID number:	10.1002/joa3.13195
URI:	https://researchonline.ljmu.ac.uk/id/eprint/25147

View Item