ArticleBMC cardiovascular disorders2021
Sex differences in treatment strategy and adverse outcomes among patients 75 and older with atrial fibrillation in the MarketScan database.
Article in BMC cardiovascular disorders, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
7 citing papers in PubMed, 14 citations in OpenAlex.
- Patterns of hormonal contraception use in women with sickle cell disease and employer-sponsored insurance.Contraception · 2026Article
- Sex-Based Disparities in Health Care Access and Utilization Among Patients With Atrial Fibrillation.JAMA network open · 2026Article
- Sex Disparities Among Lithuanian Ischemic Stroke Patients According to Laboratory Findings; Comorbidities, Including COVID-19; Acute In-Hospital Complications; and Outcomes.Medicina (Kaunas, Lithuania) · 2025Article
- Differences in Medication Use by Gender and Race in Hospitalized Persons Living with Dementia.Journal of racial and ethnic health disparities · 2024Article
- Curcumin nanoparticles in heat stroke management.Journal of nanobiotechnology · 2024Article
- Women and Atrial Fibrillation: Is the Disparity in Anticoagulation Just a Question of Gender? In Search of the Brazilian Reality.Arquivos brasileiros de cardiologia · 2024Article
- Racial, ethnic, and sex disparities in atrial fibrillation management: rate and rhythm control.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2023Review
Corrections and comments
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Authors and funding
8 authors at 5 institutions in 1 country.
Funding
Abstract
backgroundWomen with atrial fibrillation (AF) experience greater symptomatology, worse quality of life, and have a higher risk of stroke as compared to men, but are less likely to receive rhythm control treatment. Whether these differences exist in elderly patients with AF, and whether sex modifies the effectiveness of rhythm versus rate control therapy has not been assessed.
methodsWe studied 135,850 men and 139,767 women aged ≥ 75 years diagnosed with AF in the MarketScan Medicare database between 2007 and 2015. Anticoagulant use was defined as use of warfarin or a direct oral anticoagulant. Rate control was defined as use of rate control medication or atrioventricular node ablation. Rhythm control was defined by use of anti-arrhythmic medication, catheter ablation or cardioversion. We used multivariable Poisson and Cox regression models to estimate the association of sex with treatment strategy and to determine whether the association of treatment strategy with adverse outcomes (bleeding, heart failure and stroke) differed by sex.
resultsAt the time of AF, women were on average (SD) 83.8 (5.6) years old and men 82.5 (5.2) years, respectively. Compared to men, women were less likely to receive an anticoagulant or rhythm control treatment. Rhythm control (vs. rate) was associated with a greater risk for heart failure with a significantly stronger association in women (HR women = 1.41, 95% CI 1.34-1.49; HR men = 1.21, 95% CI 1.15-1.28, p < 0.0001 for interaction). No sex differences were observed for the association of treatment strategy with the risk of bleeding or stroke.
conclusionSex differences exist in the treatment of AF among patients aged 75 years and older. Women are less likely to receive an anticoagulant and rhythm control treatment. Women were also at a greater risk of experiencing heart failure as compared to men, when treated with rhythm control strategies for AF. Efforts are needed to enhance use AF therapies among women. Future studies will need to delve into the mechanisms underlying these differences.
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