Women Versus Men with Chronic Atrial Fibrillation: Insights from the Standard Versus Atrial Fibrillation spEcific managemenT studY (SAFETY)
Open accessAbstract
BACKGROUND: Gender-based clinical differences are increasingly being identified as having significant influence on the outcomes of patients with cardiovascular disease (CVD), including atrial fibrillation (AF). OBJECTIVE: To perform detailed clinical phenotyping on a cohort of hospitalised patients with chronic forms of AF to understand if gender-based differences exist in the clinical presentation, thrombo-embolic risk and therapeutic management of high risk patients hospitalised with chronic AF. METHODS: We are undertaking the Standard versus Atrial Fibrillation spEcific managemenT studY (SAFETY) - a multi-centre, randomised controlled trial of an AF-specific management intervention versus usual care. Extensive baseline profiling of recruited patients was undertaken to identify gender-specific differences for risk delineation. RESULTS: We screened 2,438 patients with AF and recruited 335 into SAFETY. Of these, 48.1% were women who were, on average, 5 years older than their male counterparts. Women and men displayed divergent antecedent profiles, with women having a higher thrombo-embolic risk but being prescribed similar treatment regimens. More women than men presented to hospital with co-morbid thyroid dysfunction, depression, renal impairment and obesity. In contrast, more men presented with coronary artery disease (CAD) and/or chronic obstructive pulmonary disease (COPD). Even when data was age-adjusted, women were more likely to live alone (odds ratio [OR] 2.33; 95% confidence interval [CI] 1.47 to 3.69), have non-tertiary education (OR 2.69; 95% CI 1.61 to 4.48) and be symptomatic (OR 1.93; 95% CI 1.06 to 3.52). CONCLUSION: Health care providers should be cognisant of gender-specific differences in an attempt to individualise and, hence, optimise the management of patients with chronic AF and reduce potential morbidity and mortality.
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Among individuals with AF, women are more likely than men to experience symptoms and to seek care for these symptoms.
“Studies indicate that among individuals with AF, women are more likely than men to experience symptoms,60,11,12 and to seek care for these symptoms.10,11”
From Atrial fibrillation in women: epidemiology, pathophysiology, presentation, and prognosis (2016) · cites this paper as [10]
Women are more likely to seek care for symptoms, which might partly be attributable to higher mean heart rates at presentation.
“Women seem to be more likely to seek care for symptoms, which might partly be attributable to higher mean heart rates at presentation.10,11”
From Atrial fibrillation in women: epidemiology, pathophysiology, presentation, and prognosis (2016) · cites this paper as [10]
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- Authors
- Ball, J., Carrington, M. J., Wood, K. A., Stewart, S., & the SAFETY Investigators
- Affiliations
- Baker Heart and Diabetes Institute (AU)
- Duke University (US)
- Corresponding author
- Stewart, Simon
- Venue
- PLoS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2013-05-29
- Volume
- 8
- Issue
- 5
- Pages
- e65795
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC3667075
- OpenAlex
- W2032200780
- Cited by
- 98
- References
- 34
- Citations by year
- 2026: 7 · 2025: 8 · 2024: 10 · 2023: 2 · 2022: 9 · 2021: 9 · 2020: 9 · 2019: 10 · 2018: 11 · 2017: 8 · 2016: 10 · 2015: 1 · 2014: 2 · 2013: 2
- FWCI
- 3.40
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- PLoS ONE (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Monash University Research Portal (Monash University) (submittedVersion, cc-by)
- Research Bank (Australian Catholic University) (submittedVersion)
- Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Minerva Access (University of Melbourne) (submittedVersion, cc-by)
- Funders
- State Government of Victoria
- Medical Research Council
- National Health and Medical Research Council (519823)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Sex and Gender in Healthcare
- Health Sciences › Medicine › Epidemiology › Acute Ischemic Stroke Management
- Keywords
- chronic atrial fibrillation, sex differences, thromboembolic risk, clinical phenotyping, hospitalized patients, anticoagulation, thyroid dysfunction, depression, renal dysfunction, obesity, coronary artery disease, chronic obstructive pulmonary disease, individualized management
- MeSH terms
- Aged, Aged, 80 and over, Atrial Fibrillation, Cardiovascular Diseases, Chronic Disease, Depression, Female, Humans, Kidney Diseases, Male, Middle Aged, Obesity, Regression Analysis, Risk Factors, Sex Factors, Thyroid Diseases, Cohort Studies, Comorbidity, Anti-Asthmatic Agents, Pulmonary Disease, Chronic Obstructive
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