International Journal of Cardiology: Heart & Vasculature (Mar 2019)

Gender differences and management of stroke risk of nonvalvular atrial fibrillation in an upper middle-income country: Insights from the CARMEN-AF registry

  • J. Antonio González-Hermosillo,
  • Manuel A. Baños-González,
  • Milton E. Guevara-Valdivia,
  • Jorge A. Vázquez-Acosta,
  • Manuel Odín de los Ríos Ibarra,
  • Kulio A. Aguilar-Linares,
  • Carlos Cantú-Brito,
  • José L. Leiva-Pons,
  • Gerardo Pozas-Garza,
  • Eddie A. Favela-Pérez,
  • Manlio F. Márquez,
  • María Sangeado Santos,
  • César González Aguilar,
  • Jorge Gómez Flores,
  • Karim Yarek Juárez Escobar,
  • Samantha Rodríguez Bastidas,
  • José Raúl de los Ríos Ibarra,
  • Carmen Summerson Lama,
  • José Paz Marcelo Jiménez Cruz,
  • Enrique Martínez Flores,
  • Norberto Matadamas Hernández,
  • Vanesa Esperanza Matadamas Carmona,
  • Candelaria Mancilla,
  • Rocío Camacho Casillas,
  • José Refugio Ramírez González,
  • Reynaldo Magaña Magaña,
  • Jorge Carrillo Calvillo,
  • Ulises Rojel Martínez,
  • Marco Antonio Alcocer Gamba,
  • Héctor Francisco Fernández Saldaña,
  • Laura Reséndiz Barrón,
  • Susano Lara Vaca,
  • Edgar Alfredo Rodríguez Salazar,
  • Humberto Rodríguez Reyes,
  • Marco Aurelio Islava Gálvez,
  • José Salvador Lainez Zelaya,
  • Lidia Evangelina Betancourt Hernández,
  • Yoloxochitl García Jiménez,
  • Sadoc Marín Rendon,
  • Nicolás Reyes Reyes,
  • Luis Gerardo Molina Fernández de Lara,
  • Carlos Gutiérrez González,
  • Fernando Flores Silva,
  • Alberto Zenón Baños Velasco,
  • Miguel Ernesto Beltrán Gámez,
  • Amanda Castelán Ojeda,
  • César Iván Vázquez Serna,
  • Miguel Ángel Negrete Rivera,
  • Alejandro Lechuga Martín del Campo,
  • Demetrio Kosturakis García,
  • Ramón Miguel Esturau Santaló,
  • José Luis Novelo Del Valle,
  • Luis Delgado Leal,
  • Luis Ángel Trujillo Muñoz,
  • José Fabián Hernández Díaz,
  • Mariano Miguel Guerra,
  • Raúl Isaac Márquez,
  • María Isabel Sánchez Ramírez,
  • Marcos Robledo,
  • José Manuel Enciso Muñoz,
  • Juan Carlos Núñez Fragoso,
  • Saúl Flores

Journal volume & issue
Vol. 22
pp. 117 – 122

Abstract

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Background: Atrial Fibrillation (AF) is associated with an increased risk of stroke and systemic embolism. Several studies have suggested that female AF patients could have a greater risk for stroke. There is scarce information about clinical characteristics and use of antithrombotic therapies in Latin American patients with nonvalvular AF. Objective: To describe the gender differences in clinical characteristics, thromboembolic risk, and antithrombotic therapy of patients with nonvalvular AF recruited in Mexico, an upper middle-income country, into the prospective national CARMEN-AF Registry. Methods: A total of 1423 consecutive patients, with at least one thromboembolic risk factor were enrolled in CARMEN-AF Registry during a three-year period (2014–2017). They were categorized according to Gender. Results: Overall, 48.6% were women, mean age 70 ± 12 years. Diabetes, smoking, alcoholism, non-ischemic cardiomyopathy, coronary artery disease, and obstructive sleep apnea were higher in men. Most women were found with paroxysmal AF (40.6%), and most men with permanent AF (44.0%). No gender differences were found in the use of vitamin K antagonists (VKA) (30.5% in women vs. 28.0% in men). No gender differences were found in the use of direct oral anticoagulants (DOAC) (33.8% women vs 35.4% men). Conclusions: CARMEN-AF Registry demonstrates that in Mexico, regardless of gender, a large proportion of patients remain undertreated. No gender differences were found in the use of VKA or DOAC. Keywords: Atrial fibrillation, Gender, Thromboembolic risk, Antithrombotic therapy, Stroke, Mexico