Sex differences in management and outcomes of patients with atrial fibrillation in the Middle East: Gulf survey of atrial fibrillation events (Gulf SAFE)

Abdulla Shehab 1, Mohammad Zubaid 2, Akshaya Srikanth Bhagavathula 3, Wafa A Rashed 4, Alawi A Alsheikh-Ali 5, Wal AlMahmeed 5, Kadhim Sulaiman 6, Ibrahim Al-Zakwani 7, Ahmed AlQudaimi 8, Nidal Asaad 9, Haitham Amin 10; Gulf Survey of Atrial Fibrillation Events (Gulf SAFE) investigators

Affiliations

doi: 10.1371/journal.pone.0175405

Abstract

Differences in the management of atrial fibrillation (AF) between men and women were investigated by using Gulf SAFE data in the Middle East. The study included 2,043 patients presenting with AF to emergency room (ER) were prospectively enrolled and followed for one-year. Women were older, have higher body mass index (BMI), comorbidities, and health complications than men. With regard to management of AF, cardioversion was recommended more often for men (16.7% vs. 9.3%), and underwent electrical cardioversion (2.2% vs. 1.1%). Women were prescribed digoxin more frequently than men (25.6% vs. 17.4%) and a significant number women received warfarin alone (31.1% vs. 8.7%). No difference between the sexes was noticed in One-year rates of stroke/transient ischemic attacks (TIA) and all-cause of mortality after one-year follow-up (3.1% men vs. 3.3% women, and 7.5% vs. 7.4%). Older age (≥ 65 years), smoking, alcohol use, CHADS2 scores ≥5 were some of the significant risk factors in men with AF. Suboptimal use of anticoagulants, higher mortality and stroke/TIA events at one year are high but similar between the sexes. ER management revealed high use of rate control strategy and high rate of hospital admission was noticed in women.

Conflict of interest statement

Competing Interests: This study was sponsored by Sanofi Aventis. There are no patents, products in development or marketed products to declare. This does not alter our adherence to all the PLOS ONE policies on sharing data and materials.

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