Results of previous studies regarding gender differences and the risk of thromboembolism (TE) in the setting of atrial fibrillation (AF) have been conflicting. A recent study by Fang et al, published in Circulation, however, suggests that women may have a greater risk of TE than men. The investigators conducted a study of over 13,000 patients with AF and recorded data on patients' clinical characteristics and occurrences of hospitalizations for ischemic stroke, hemorrhagic events, and peripheral embolism. An extensive analysis of the data suggested that the rate of TE in women was twice as high in those not taking warfarin. Warfarin use was associated with significantly lower event rates in both sexes. Annual rates of major hemorrhage were similar for men and women. The authors concluded that women are at higher risk for AF-related events off warfarin and that female sex should be considered as an independent risk factor for TE in the setting of AF.
Dr. Garrett is a clinical pharmacist practitioner at Cornerstone Health Care in High Point, NC.