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Calvert, P, Chen, Y, Gue, Y, Gupta, D, Azariah, JL, George Koshy, A, Zachariah, G, Natarajan, KU, Lip, GYH, 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 , Mohanan, PP, George, R, Unni, G, Sajeev, CG, Syam, N, Roby, A, Daniel, R, Krishnakumar, VV, Pillai, AM, Joseph, S, Mini, GK, Koya, SF, Eapen, K, Ram, R, Mathew, C, Faizal, A, Issac, B, Renga, S, Menon, J, Harikrishna, D, Suresh, K, Nair, T, Susanth, SS, Kumar, RA, Abilash, TP, Sreekala, P, Rajeev, E, Raj, A, Naik, R, Gopinath, A, Binu, R, Chacko, J, Iqbal, PT, Sudhir, NM, Sreedharan, M, Balakrishnan, N, Musthaffa, M, Jayakumar, B, George, S, Kumar, A, Mathew, T, Pramod, VK, Shaloob, M, Chandy, MP, Vinod, KR, Das, K, Ahamad, ZS and Mathew, P (2024) Sex differences in atrial fibrillation in India: Insights from the Kerala-AF registry. Journal of Arrhythmia. ISSN 1880-4276
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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 |
| SWORD Depositor: | A Symplectic |
| Date Deposited: | 20 Dec 2024 10:57 |
| Last Modified: | 20 Dec 2024 10:57 |
| DOI or ID number: | 10.1002/joa3.13195 |
| URI: | https://researchonline.ljmu.ac.uk/id/eprint/25147 |
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