engleski

Gender differences in recurrent stroke among patients with atrial fibrillation receiving anticoagulants

Introduction/Objectives: Gender differences in stroke are observed across epidemiological studies, incidence, etiology, presentation and outcome. The aim of our study was to analyze gender differences in recurrent stroke among patients with atrial fibrillation (AF) receiving oral anticoagulants (OA). Participants, Materials/Methods: This retrospective study included 141 consecutive patients with previously known AF receiving OA hospitalized with recurrent stroke from 2004 to 2015. Patient were divided into two groups according to gender: 87 women and 54 men. Stroke severity was assessed according to National Institutes of Health Stroke Scale (NIHSS). Stroke outcome was assessed by modified Rankin scale (mRS). Results: Women were older (p=0.001) and had a higher CHADS2 score (p=0.007). Mortality was higher among men (37%) than among women (21%) ; p=0.033. No significant difference was found in risk factors (besides age), stroke localization, presentation, mRS before and after stroke onset between groups. No significant difference was found in INR (International Normalized Ratio) levels or in the optimal INR ratio (2-3) between groups ; only 18% of women and 22% of men were optimally anticoagulated at stroke onset. There were 2 haemorrhagic strokes in total. 77% of women and 79% of men continued OA in stroke prevention. Conclusions: Our results show that women with AF have recurrent stroke more often, but men are affected at a younger age with a fatal outcome more often. Only 1, 4% of all strokes were haemorrhagic. An emphasis should be put on further efforts to achieve optimal anticoagulation in appropriate patients populations to maximize the benefit with minimal complications.

gender ; stroke ; atrial fibrillation ; anticoagulant

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