Gender differences in clinical presentation and 1-year outcomes in atrial fibrillation

Research output: Contribution to journalArticlepeer-review


  • Renate B Schnabel
  • Ladislav Pecen
  • Francisco M Ojeda
  • Markus Lucerna
  • Nargiz Rzayeva
  • Stefan Blankenberg
  • Harald Darius
  • Raffaele De Caterina

Colleges, School and Institutes

External organisations

  • Medical Facility Pilsen of Charles University, Pilsen, Czech Republic.
  • Department of Cardiology, University Heart Center Hamburg-Eppendorf, German Center for Cardiovascular Research (DZHK) partner site Hamburg/Kiel/Lübeck, Hamburg, Germany.
  • Daiichi Sankyo Europe GmbH, Munich, Germany.
  • Department of Cardiology, Angiology, Nephrology and Conservative Intensive Care Medicine, Vivantes Klinikum Neukolln, Berlin, Germany.
  • Centre for Cardiovascular Sciences; School of Clinical and Experimental Medicine; University of Birmingham; Edgbaston Birmingham UK
  • G. d'Annunzio University of Chieti-Pescara
  • Institute of Cardiovascular Sciences, University of Birmingham and SWBH and UHB NHS Trust, Birmingham, UK.


OBJECTIVES: Our objective was to examine gender differences in clinical presentation, management and prognosis of atrial fibrillation (AF) in a contemporary cohort.

METHODS: In 6412 patients, 39.7% women, of the PREvention oF thromboembolic events - European Registry in Atrial Fibrillation, we examined gender differences in symptoms, risk factors, therapies and 1-year incidence of adverse outcomes.

RESULTS: Men with AF were on average younger than women (mean±SD: 70.1±10.7 vs 74.1±9.7 years, p<0.0001). Women more frequently had at least one AF-related symptom at least occasionally compared with men (95.4% in women, 89.8% in men, p<0.0001). Prescription of oral anticoagulation was similar, with an increase of non-vitamin K antagonist oral anticoagulants from 5.9% to 12.6% in women and from 6.2% to 12.6% in men, p<0.0001 for both.Men were more frequently treated with electrical cardioversion and ablation (20.6% and 6.3%, respectively) than women (14.9% and 3.3%, respectively), p<0.0001. Women had 65% (OR: 0.35; 95% CI (0.22 to 0.56)) lower age-adjusted and country-adjusted odds of coronary revascularisation, 40% (OR: 0.60; (0.38 to 0.93)) lower odds of acute coronary syndrome and 20% (OR: 0.80; (0.68 to 0.96)) lower odds of heart failure at 1 year. There were no statistically significant gender differences in 1-year stroke/transient ischaemic attack/arterial thromboembolism and major bleeding events.

CONCLUSION: In a 'real-world' European AF registry, women were more symptomatic but less likely to receive invasive rhythm control therapy such as electrical cardioversion or ablation. Further study is needed to confirm that these differences do not disadvantage women with AF.


Original languageEnglish
Publication statusPublished - 22 Feb 2017