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Atrial fibrillation's impact much worse in women than in men; cardiovascular mortality.

VIENNA -- Atrial fibrillation is a far more powerful risk factor for both stroke and cardiovascular death in women than in men, according to new data from the Copenhagen City Heart Study

The Danish epidemiologic study is a population-based cohort study in which 29,310 adult residents of Copenhagen, including 15,206 with no history of stroke at enrollment, have been followed for a total of 137,391 person-years to date.

During that period, 166 men and 110 women developed documented atrial fibrillation (AF). Of the 635 first-ever strokes that occurred during follow-up, 35 occurred in participants with AF, of whom 22 were women, Dr. Jens Friberg reported at the annual congress of the European Society of Cardiology.

The risk of a first stroke was determined to be 7.8-fold greater in women with AF than in those without the arrhythmia after adjustment for age, diabetes, hypertension, acute MI, left ventricular hypertrophy, and smoking. In contrast, the adjusted risk of stroke in men with AF was 1.7-fold greater than in men without AE That means the independent impact of AF upon stroke risk was 4.6-fold greater in women than in men, said Dr. Friberg of Bispebjerg University Hospital, Copenhagen.

Cardiovascular death has occurred in 1,122 Copenhagen City Heart Study participants, including 28 women and 35 men with AE The adjusted risk of cardiovascular death was 4.4-fold greater in women with AF than in those without it, and 2.2-fold greater in men with AF than in those without it. Thus, the independent effect of AF upon risk of cardiovascular death was twice as great in women as in men.

It's unclear why. One speculation is that since AF is considerably more prevalent among men, it may be that in order for a woman to develop AF she needs to have a sicker heart than men with the arrhythmia in ways that have not yet been identified, the cardiologist said.
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Author:Jancin, Bruce
Publication:Internal Medicine News
Date:Oct 1, 2003
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