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A new study published in the May 9 issue of JAMA reveals that older women, especially those aged 75+, who receivethe anticoagulant therapy warfarin after diagnosis of atrial fibrillation are more likely to suffer astroke than men. The researchers explained: "Atrial fibrillation (AF) is the most common cardiac arrhythmia , accounting for approximately one-third of hospitalizations forcardiac rhythm disturbances. It has been estimated that 2.2 millionpeople in the United States and 4.5 million in the European Unionhave paroxysmal or persistent AF. Patients with AF have a five-fold increase in the risk of stroke compared with the general population; therefore, antithromboticagents are prescribed to reduce this risk. Sex-based differencesrelated to AF have been identified, the most concerning being thatwomen with AF have an increased risk for cardiovascular events,including stroke." According to the researchers, underutilization of oralanticoagulant treatment among women may contribute to thisincreased risk. In order to compare usage patterns of warfarin and subsequentstroke incidence, Meytal Avgil Tsadok, Ph.D., of the McGillUniversity Health Center, Montreal and colleagues examined 39,398men and 44,115 women aged 65+ diagnosed with AF in the province ofQuebec, Canada, from 1998-2007. The researchers used administrative data with linkage betweenphysicians, hospital discharge, and prescription drug claimsdatabases. According to the authors, the women were older at admission (74.2%were older than 75 years) than men (61.4%). In addition, the womenhad a higher CHADS2 (congestive heart failure , hypertension , diabetes mellitus, age 75+, prior stroke or transient ischemic attack ) score than men. Furthermore, they found that 60.6% of women were prescribedwarfarin compared with 58.2% of men, and that the women were alsomore likely to have more prescriptions filled for the medicationwithin 30 days post-discharge. When the team evaluated prescription rates within 1 year afterdischarge, they found that the proportions of prescriptions filledwere slightly increased to 68% in both men and women. Generally,adherence to the treatment was relatively high and comparable inboth women and men. In addition, stroke rates were considerably higher in women (5.8%)than men (4.3%). The difference between sexes was primarily drivenby the rates in patients aged 75+. The researchers explained: "Furthermore, older women had significantly higher rates of strokethan older men, regardless of warfarin use, and women had higherrates of stroke compared with men, regardless of adherence level." After adjusting for various factors, the team found that women were14% more likely to suffer a stroke than men. The authors stressed that exactly why women have a higher risk ofstroke than men, in such cases, is still unknown. "The increased risk may be attributable to physiology (such asuncontrolled hypertension), vascular biology, genetic factors,hormonal or thromboembolic factors, or psychosocial factors thatdiffer between men and women. We were not able to identify thesefactors with our database." They concluded: "Although epidemiologic studies have investigated sex differencesin stroke occurrence, little is known about warfarin effectivenessbetween men and women in the real-world clinical setting. Our results suggest that elderly women with AF may need to betargeted for more effective stroke prevention therapy. Cliniciansshould be aware of the elevated stroke risk in older women with AF,and new strategies should be applied to effectively prevent strokeequally in men and women. Written by Christian Nordqvist. We are high quality suppliers, our products such as China IPhone Screw Driver , IPad Flex Cable Manufacturer for oversee buyer. To know more, please visits Apple IPod Spare Parts.
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