Gender-related differences in management of nonvalvular atrial fibrillation in an asian population

Jung Myung Lee, Tae Hoon Kim, Myung Jin Cha, Junbeom Park, Jin Kyu Park, Ki Woon Kang, Jaemin Shim, Jae Sun Uhm, Jun Kim, Hyung Wook Park, Young Soo Lee, Eue Keun Choi, Chang Soo Kim, Boyoung Joung, Jin Bae Kim

    Research output: Contribution to journalArticlepeer-review

    19 Citations (Scopus)


    Background and Objectives: Gender-related differences in health care utilization for atrial fbrillation (AF) are increasingly recognized. However, large cohort data for examining gender-related differences in AF are lacking in Asian populations. Methods: The Registry for Comparison Study of Drugs for Symptom Control and Complication Prevention of AF (CODE-AF Registry) is a prospective observational cohort-study that enrolled participants at 10 tertiary hospitals in South Korea. Baseline characteristics retrieved from the CODE-AF Registry were analyzed. Results: A total of 6,274 patients were recruited (mean age 67±11 years, mean CHA2DS2-VASc score 2.7±1.7, 63% male, 65% paroxysmal AF) from June 2016 to April 2017. Women underwent less electric cardioversion (12.3% vs. 19.6%, p<0.001), less radiofrequency ablation (12.4% vs. 17.9%, p<0.001), and less antiarrhythmic drug therapy (44.7% vs. 49.5%, p<0.001), despite having more severe symptoms (symptom class III or IV, 45.8% vs. 37.5%, p<0.001). Among patients with a CHA2DS2-VA score of 2 or more, a slightly higher proportion of women were taking oral anticoagulants than men (85.7% vs. 81.9%, p=0.002), and nonvitamin K antagonist oral anticoagulant (NOAC) use was more prevalent in women than men (70.4% vs. 62.3%, p<0.001). Insufcient NOAC dosing was very common, more so in women than men (61.5% vs. 56.3%, p<0.001). Conclusions: Female patients with AF were treated more conservatively and rhythm control strategies were used less frequently than in males, even though the female patients with AF had more severe symptoms. While insufcient NOAC dosing was common in both sex, it was signifcantly more frequent in women.

    Original languageEnglish
    Pages (from-to)519-528
    Number of pages10
    JournalKorean Circulation Journal
    Issue number6
    Publication statusPublished - 2018 Jun

    Bibliographical note

    Funding Information:
    This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF), which is funded by the Ministry of Science, ICT & Future Planning (NRF-2012R1A2A2A02045367, 2010-0021993). This work was also supported by grants from the Korean Healthcare Technology R & D Project, which is funded by the Ministry of Health & Welfare (HI12C1552, HI16C0058, and HI15C1200).

    Publisher Copyright:
    © 2018 The Korean Society of Cardiology.


    • Anticoagulants
    • Asian ceancestry group
    • Atrial fbrillation
    • Registries
    • Sex characteristics

    ASJC Scopus subject areas

    • Internal Medicine
    • Cardiology and Cardiovascular Medicine


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