GENDER DIFFERENCES IN PATIENTS WITH ATRIAL FIBRILLATION SHOWN BY TRANSTHORACIC ECHOCARDIOGRAPHY AND COMPUTED TOMOGRAPHY

Abstract

Relevance: Cardioembolism is one of the major causes of ischemic strokes and accounts for 15-30% of all cerebral infarctions. Atrial
 fibrillation (AF) accounts for up to 60% of cardioembolic strokes. Assessing thromboembolic risk is important for patients with AF; however, these concerns do not apply equally to men and women.
 The study aimed to determine gender differences in echocardiographic and computed tomography characteristics of patients with
 atrial fibrillation.
 Methods: The included 202 patients underwent both transthoracic echocardiography and computed tomography. We excluded patients
 with allergies to iodide, increased creatinine levels, hyperthyroidism, pregnancy, and age <18 years.
 Results: An increase in BMI by 1 kg/m2
 in female patients increased the risk of left-atrium appendage (LAA) thrombus by 10% (OR=1,1,
 p=0.019). The yearly increase in the age of women lowers the risk of LAA thrombosis by 6% (OR=0,94, р=0,01). Each increase of EDD in
 women to 1 cm raises the risk of LAA thrombosis by 151% (OR=2,51, p=0.031). Each increase of ESV and EDV in women to 1 ml raises the
 risk of LAA thrombosis by 4% and 3%, respectively (p<0.05). Each increase of LVESVI and LVEDVI in female patients to 1 ml/m2 raises the
 risk of LAA thrombosis by 6% and 5%, respectively (p<0.05).
 Older age, higher CHA2
 -DS2
 -VASc, HAS-BLED scores, and enlarger LA in male patients were significantly associated with LAA
 thrombosis.
 The yearly increase in the age of men increases the risk of LAA thrombosis by 5% (OR=1.05, p=0.012). Men with coronary atherosclerosis at risk of thrombosis by 224% (OR=3,24, p=0.002).
 Conclusion: improved clinician understanding of gender differences may help clinicians better care for individuals with AF