Gender-related differences in risk of cardiovascular morbidity and all-cause mortality in patients hospitalized with incident atrial fibrillation without concomitant diseases: A nationwide cohort study of 9519 patients
Open accessAbstract
BACKGROUND: Previous studies of patients with "lone" and "idiopathic" atrial fibrillation (AF) have provided conflicting evidence concerning the development, management and prognosis of this condition. METHODS: In this nation-wide, retrospective, cohort study, we studied patients diagnosed with incidental AF recorded in national Swedish registries between 1995 and 2008. Controls were matched for age, sex and calendar year of the diagnosis of AF in patients. All subjects were free of any in-hospital diagnosis from 1987 and until patients were diagnosed with AF and also free of any diagnosis within one year from the time of inclusion. Follow-up continued until 2009. We identified 9519 patients (31% women) and 12,468 matched controls. RESULTS: Relative risks (RR) versus controls for stroke or transient ischemic attack (TIA) in women were 19.6, 4.4, 3.4 and 2.5 in the age categories <55, 55-64, 65-74 and 75-85, years respectively. Corresponding figures for men were 3.4, 2.5, 1.7 and 1.9. RR for heart failure were 6.6, 6.6, 6.3 and 3.8 in women and 7.8, 4.6, 4.9 and 2.9 in men. All RR were statistically significant with p < 0.01. RR for myocardial infarction and all-cause mortality were statistically significantly increased only in the two oldest age categories in women and 65-74 years in men. CONCLUSIONS: Patients with AF and no co-morbidities at inclusion had at least a doubled risk of stroke or TIA and a tripled risk of heart failure, through all age categories, as compared to controls. Women were at higher RR of stroke or TIA than men.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Female AF patients who have additional stroke risk factors, particularly older age, are at greater risk than men of having a stroke, even those anticoagulated with warfarin.
“Female AF patients who have additional stroke risk factors (particularly older age) are also at greater risk than men of having a stroke, 48,49 even those anticoagulated with warfarin 50 (see Chapter 8 for details).”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [48]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Dabigatran versus warfarin in patients with atrial fibrillation
Connolly, S. J., Ezekowitz, M. D., Yusuf, S., Eikelboom, J., Oldgren, J., Parekh, A., Pogue, J., Reilly, P. A., Themeles, E., Varrone, J., et al. (2009) · New England Journal of Medicine · doi:10.1056/nejmoa0905561 · Cited by 11,215 · see citing works
Rivaroxaban versus warfarin in nonvalvular atrial fibrillation
Patel, M. R., Mahaffey, K. W., Garg, J., Pan, G., Singer, D. E., Hacke, W., Breithardt, G., Halperin, J. L., Hankey, G. J., Piccini, J. P., et al. (2011) · New England Journal of Medicine · doi:10.1056/nejmoa1009638 · Cited by 9,430 · see citing works
Apixaban versus warfarin in patients with atrial fibrillation
Granger, C. B., Alexander, J. H., McMurray, J. J. V., Lopes, R. D., Hylek, E. M., Hanna, M., Al-Khalidi, H. R., Ansell, J., Atar, D., Avezum, A., et al. (2011) · New England Journal of Medicine · doi:10.1056/nejmoa1107039 · Cited by 8,943 · see citing works
2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation
January, C. T., Wann, L. S., Alpert, J. S., Calkins, H. G., Cigarroa, J. E., Cleveland, J. C., CONTI, J. B., Ellinor, P. T., Ezekowitz, M. D., Field, M. E., et al. (2014) · Circulation · doi:10.1161/cir.0000000000000041 · Cited by 7,119 · see citing works
Lip, G. Y. H., Nieuwlaat, R., Pisters, R., Lane, D. A., & Crijns, H. J. G. M. (2010) · Chest · doi:10.1378/chest.09-1584 · Cited by 6,879 · see citing works
External review and validation of the Swedish national inpatient register
Ludvigsson, J. F., Andersson, E., Ekbom, A., Feychting, M., Kim, J.-L., Reuterwall, C., Heurgren, M., & Olausson, P. O. (2011) · BMC Public Health · doi:10.1186/1471-2458-11-450 · Cited by 5,055 · see citing works
Gage, B. F., Waterman, A. D., Shannon, W., Boechler, M., Rich, M. W., & Radford, M. J. (2001) · JAMA · doi:10.1001/jama.285.22.2864 · Cited by 4,832 · see citing works
2012 focused update of the ESC Guidelines for the management of atrial fibrillation
Authors Task Force Members, Camm, A. J., Lip, G. Y. H., Caterina, R. D., Savelieva, I., Atar, D., Hohnloser, S. H., Hindricks, G., Kirchhof, P. F., Bax, J. J., et al. (2012) · EP Europace · doi:10.1093/europace/eus305 · Cited by 3,814 · see citing works
2012 focused update of the ESC Guidelines for the management of atrial fibrillation
Authors Task Force Members, Camm, A. J., Lip, G. Y. H., Caterina, R. D., Savelieva, I., Atar, D., Hohnloser, S. H., Hindricks, G., Kirchhof, P. F., Bax, J. J., et al. (2012) · European Heart Journal · doi:10.1093/eurheartj/ehs253 · Cited by 2,898 · see citing works
The epidemiology of heart failure: The Framingham Study
Ho, K. K. L., Pinsky, J. L., Kannel, W. B., & Levy, D. A. (1993) · Journal of the American College of Cardiology · doi:10.1016/0735-1097(93)90455-a · Cited by 2,230 · see citing works
Stewart, S., Hart, C. L., Hole, D. J., & McMurray, J. J. V. (2002) · The American Journal of Medicine · doi:10.1016/s0002-9343(02)01236-6 · Cited by 1,562 · see citing works
Olesen, J. B., Lip, G. Y. H., Hansen, M. L., Hansen, P. R., Tolstrup, J. S., Lindhardsen, J., Selmer, C., Ahlehoff, O., Olsen, A.-M. S., Gislason, G. H., et al. (2011) · BMJ · doi:10.1136/bmj.d124 · Cited by 1,428 · see citing works
Friberg, L., Rosenqvist, M., & Lip, G. Y. H. (2012) · European Heart Journal · doi:10.1093/eurheartj/ehr488 · Cited by 1,192 · see citing works
Thrombus Aspiration during ST-Segment Elevation Myocardial Infarction
Fröbert, O., Lagerqvist, B., Olivecrona, G. K., Ömerovic, E., Guðnason, Þ., Mæng, M., Aasa, M., Angerås, O., Calais, F., Danielewicz, M., et al. (2013) · New England Journal of Medicine · doi:10.1056/nejmoa1308789 · Cited by 1,152 · see citing works
Self-citationPrevalence of atrial fibrillation in elderly subjects (the Cardiovascular Health Study)
Furberg, C. D., Psaty, B. M., Manolio, T. A., Gardin, J. M., Smith, V. E., & Rautaharju, P. M. (1994) · The American Journal of Cardiology · doi:10.1016/0002-9149(94)90363-8 · Cited by 1,096 · see citing works
The Natural History of Lone Atrial Fibrillation
Kopecky, S. L., Gersh, B. J., McGoon, M. D., Whisnant, J. P., Holmes, D. R., Ilstrup, D. M., & Frye, R. L. (1987) · New England Journal of Medicine · doi:10.1056/nejm198709103171104 · Cited by 936 · see citing works
Characteristics and Prognosis of Lone Atrial Fibrillation
Brand, F. N. (1985) · JAMA · doi:10.1001/jama.1985.03360240061035 · Cited by 610 · see citing works
Fúster, & Westerling, R. (2001) · Circulation · Cited by 607 · see citing works
Fuster, V., Rydén, L., ASINGER, R. W., Cannom, D. S., Crijns, H. J. G. M., Frye, R. L., Halperin, J. L., Kay, G. N., Klein, W. W., Lévy, S., et al. (2001) · Circulation · doi:10.1161/circ.104.17.2118 · Cited by 607 · see citing works
Characterization of Different Subsets of Atrial Fibrillation in General Practice in France
Lévy, S., Maarek, M., Coumel, P., Guize, L., Lekieffre, J., Medvedowsky, J. L., & Sebaoun, A. (1999) · Circulation · doi:10.1161/01.cir.99.23.3028 · Cited by 580 · see citing works
Identifying Patients at High Risk for Stroke Despite Anticoagulation
Lip, G. Y. H., Frison, L., Halperin, J. L., & Lane, D. A. (2010) · Stroke · doi:10.1161/strokeaha.110.590257 · Cited by 493 · see citing works
Fuster, V., Rydén, L., ASINGER, R. W., Cannom, D. S., Crijns, H. J. G. M., Frye, R. L., Halperin, J. L., Kay, G. N., Klein, W. W., Lévy, S., et al. (2001) · European Heart Journal · doi:10.1053/euhj.2001.2983 · Cited by 489 · see citing works
Schmidt, M., Jacobsen, J. B., Lash, T. L., Bøtker, H. E., & Sørensen, H. T. (2012) · BMJ · doi:10.1136/bmj.e356 · Cited by 461 · see citing works
Friberg, L., Rosenqvist, M., & Lip, G. Y. H. (2012) · Circulation · doi:10.1161/circulationaha.111.055079 · Cited by 454 · see citing works
Andersson, T., Magnuson, A., Bryngelsson, I., Fröbert, O., Henriksson, K. M., Edvardsson, N. G., & Poçi, D. (2013) · European Heart Journal · doi:10.1093/eurheartj/ehs469 · Cited by 450 · see citing works
Self-citationJahangir, A., Lee, V., Friedman, P. A., Trusty, J. M., Hodge, D. O., Kopecky, S. L., Packer, D. L., Hammill, S. C., Shen, W.-K., & Gersh, B. J. (2007) · Circulation · doi:10.1161/circulationaha.106.644484 · Cited by 392 · see citing works
Sarno, G., Lagerqvist, B., Fröbert, O., et al. (2012) · European Heart Journal · doi:10.1093/eurheartj/ehr479 · Cited by 378 · see citing works
Self-citationEckman, M. H., Singer, D. E., Rosand, J. M., & Greenberg, S. M. (2010) · Circulation Cardiovascular Quality and Outcomes · doi:10.1161/circoutcomes.110.958108 · Cited by 276 · see citing works
Friberg, L., Benson, L., Rosenqvist, M. A., & Lip, G. Y. H. (2012) · BMJ · doi:10.1136/bmj.e3522 · Cited by 268 · see citing works
Lévy, S. (2003) · EP Europace · doi:10.1053/eupc.2002.0300 · Cited by 147 · see citing works
Lone Atrial Fibrillation in Elderly Persons
Kopecky, S. L., Gersh, B. J., McGoon, M. D., Chu, C.-P., Ilstrup, D. M., Chesebro, J. H., & Whisnant, J. P. (1999) · Archives of Internal Medicine · doi:10.1001/archinte.159.10.1118 · Cited by 98 · see citing works
Trends in incidence and case fatality rates of acute myocardial infarction in Denmark and Sweden
Abildstrom, S. Z., Rasmussen, S., Rosén, M., & Madsen, M. (2003) · Heart · doi:10.1136/heart.89.5.507 · Cited by 96 · see citing works
Idiopathic atrial fibrillation as a risk factor for mortality.The Paris Prospective Study I
Jouven, X. (1999) · European Heart Journal · doi:10.1053/euhj.1998.1397 · Cited by 89 · see citing works
Gender and heart failure: a population perspective
Mehta, P. A., & Cowie, M. (2006) · Heart · doi:10.1136/hrt.2005.070342 · Cited by 89 · see citing works
Taillandier, S., Olesen, J. B., Clémenty, N., Lagrenade, I., Babuty, D., Lip, G. Y. H., & Fauchier, L. (2012) · Journal of Cardiovascular Electrophysiology · doi:10.1111/j.1540-8167.2011.02257.x · Cited by 41 · see citing works
Weijs, B., de Vos, C. B., Tieleman, R. G., Peeters, F. E. C. M., Limantoro, I., Kroon, A. A., Cheriex, E. C., Pisters, R., & Crijns, H. J. G. M. (2012) · EP Europace · doi:10.1093/europace/eus203 · Cited by 35 · see citing works
Can We Predict Stroke in Atrial Fibrillation?
Lip, G. Y. H. (2012) · Clinical Cardiology · doi:10.1002/clc.20969 · Cited by 35 · see citing works
Frost, L. (2007) · Circulation · doi:10.1161/circulationaha.107.709287 · Cited by 30 · see citing works
Idiopathic atrial fibrillation: a rose by any other name?
Wyse, D. G. (2012) · EP Europace · doi:10.1093/europace/eur423 · Cited by 10 · see citing works
Flagged first, then by citations
Research works printed but not linked: 5
- Lévy S. International consensus on nomenclature and classification of atrial fibrilla- tion. Europace 2003;5:119-22.
- Jouven X, Desnos M, Guerot C, Ducimetiere P. Idiopathic atrial fibrillation as a risk factor for mortality. Eur Heart J 1999;20:896-9.
- Wyse DG. Idiopathic AF: a rose by any other name? Europace 2012;14(2):151-2.
- Bleumink GS, Knetsch AM, Sturkenboom M, et al. Quantifying the heart failure epidemic: prevalence, incidence rate, lifetime risk and prognosis of heart failure: the Rotterdam Study. Eur Heart J 2004;25:1614-9.
- Gage BF, Waterman AD, Shannon W, Boechler M, Rich MW, Radford MJ. Validation of clinical classification schemes for predicting stroke. JAMA 2001;285:2864-70.
Cited by
Sorted by citations
2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS
Kirchhof, P., Benussi, S., Kotecha, D., Ahlsson, A., Atar, D., Casadei, B., Castella, M., Diener, H.-C., Heidbuchel, H., Hendriks, J., et al. (2016) · European Heart Journal · doi:10.1093/eurheartj/ehw210 · Cited by 6,418 · see citing works
January, C. T., Wann, L. S., Calkins, H., Chen, L. Y., Cigarroa, J. E., Cleveland, J. C., Ellinor, P. T., Ezekowitz, M. D., Field, M. E., Furie, K. L., et al. (2019) · Circulation · doi:10.1161/cir.0000000000000665 · Cited by 2,744 · see citing works
2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS
Kirchhof, P., Benussi, S., Kotecha, D., Ahlsson, A., Atar, D., Casadei, B., Castella, M., Diener, H.-C., Heidbuchel, H., Hendriks, J., et al. (2016) · European Journal of Cardio-Thoracic Surgery · doi:10.1093/ejcts/ezw313 · Cited by 1,403 · see citing works
Emdin, C. A., Wong, C. X., Hsiao, A. J., Altman, D. G., Peters, S. A., Woodward, M., & Odutayo, A. A. (2016) · BMJ · doi:10.1136/bmj.h7013 · Cited by 452 · see citing works
Atrial fibrillation in women: epidemiology, pathophysiology, presentation, and prognosis
Ko, D., Rahman, F., Schnabel, R. B., Yin, X., Benjamin, E. J., & Christophersen, I. E. (2016) · Nature Reviews Cardiology · doi:10.1038/nrcardio.2016.45 · Cited by 353 · see citing works
- Authors
- Andersson, T., Magnuson, A., Bryngelsson, I.-L., Frøbert, O., Henriksson, K. M., Edvardsson, N., & Poçi, D.
- Affiliations
- Örebro University Hospital (SE)
- Uppsala University (SE)
- Sahlgrenska University Hospital (SE)
- Corresponding author
- Andersson, Tommy
- Venue
- International Journal of Cardiology
- Publisher
- Elsevier BV
- Published
- 2014-11
- Volume
- 177
- Issue
- 1
- Pages
- 91-99
- ISSN
- 0167-5273 (ISSN-L)
- OpenAlex
- W2111883983
- Cited by
- 68
- References
- 39
- Citations by year
- 2026: 3 · 2024: 4 · 2023: 3 · 2022: 10 · 2021: 2 · 2020: 6 · 2019: 8 · 2018: 9 · 2017: 8 · 2016: 9 · 2015: 5 · 2014: 1
- FWCI
- 5.27
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- International Journal of Cardiology (publishedVersion, cc-by-nc-sa)
- PubMed (publishedVersion)
- KTH Publication Database DiVA (KTH Royal Institute of Technology) (submittedVersion, other-oa)
- Scopus (Elsevier) (submittedVersion, other-oa)
- Funders
- AstraZeneca R&D Mölndal
- Örebro Heart Foundation
- Örebro University Hospital (OLL 2012-265231)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Epidemiology › Acute Ischemic Stroke Management
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cardiovascular and Diving-Related Complications
- Keywords
- atrial fibrillation, lone atrial fibrillation, sex differences, cardiovascular morbidity, stroke, transient ischemic attack, heart failure, myocardial infarction, all-cause mortality, prognosis
- MeSH terms
- Aged, Aged, 80 and over, Atrial Fibrillation, Cause of Death, Female, Follow-Up Studies, Humans, Inpatients, Male, Middle Aged, Morbidity, Population Surveillance, Prognosis, Retrospective Studies, Sex Factors, Sweden, Survival Rate
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
