Abstract 16129: The Gender Difference in Risk Factors and Incidence Rate of Ischemic Stroke in Japanese Atrial Fibrillation Patients: The Fushimi AF Registry

Abstract

Background: Gender-specific medicine is of concern in cardiovascular medicine. We previously reported that there was not gender difference in the incidence of ischemic stroke from the Fushimi AF Registry. However, the gender difference in risk factors of ischemic stroke in Japanese atrial fibrillation (AF) patients is little known. The aim of this study is to compare the risk factors and incidence rate of ischemic stroke in male and female using the latest data with longer follow-up. Method: In the Fushimi AF Registry, follow-up data were available for 4,496 patients. In the entire cohort, 2,677 were male and 1,819 were female. We compared clinical characteristics and risk factors and incidence rate of ischemic stroke between the two groups. Result: Male patients were younger (male vs. female; 71.5 years vs. 76.7 years, p<0.01), greater in body weight (65.0 kg vs. 51.2 kg, p<0.01), were more often sustained type (52.0% vs. 48.2%, p=0.04), more likely to have diabetes mellitus (26.2% vs. 19.9%, p<0.01), coronary artery disease (16.0% vs. 12.3%, p<0.01) and less likely to have prior heart failure (24.0% vs. 32.3%, p<0.01), chronic kidney disease (CKD) (33.7% vs. 39.3%, p<0.01) and had lower CHADS 2 score (1.96 vs. 2.15, p<0.01). In prescription data, male patients more often received oral anticoagulant (58.2% vs. 52.1%, p<0.01) and antiplatelet drug (APD) (29.0% vs. 23.8%, p<0.01). Hypertension, left atrium enlargement (LAE), previous stroke and major bleeding were comparable between the two groups. During the median follow-up of 1,824 days (longest 10 years), the incidence rate of ischemic stroke was not significantly different between two groups (0.86 vs. 0.89% per person-year, log rank p=0.32). On multivariate Cox regression analysis, age, previous stroke and LAE were significantly associated with an increased risk of ischemic stroke in both groups. CKD and prescription of APD were significantly associated with an increased risk of ischemic stroke in male, while body weight was in female. Conclusion: The incidence rate of ischemic stroke was not significantly different between male and female. The risk factors associated with ischemic stroke were different between male and female in Japanese AF patients.