PO-05-200 GENDER DISPARITIES IN MANAGEMENT AND OUTCOMES OF ATRIAL FIBRILLATION IN A MODERN LOUISIANA COHORT

Abstract

Female gender is associated with a lower lifetime risk of developing atrial fibrillation (AF) when compared to males. Other gender differences in atrial fibrillation comorbidities, treatments, and outcomes have been described with often conflicting results. We sought to investigate gender differences in comorbidities, treatments, and outcomes of atrial fibrillation patients from a recent Louisiana population. Data on patients aged ≥18 years diagnosed with atrial fibrillation between January 2010 and December 2019 was pulled from the Research Action for Health Network database (REACHnet). The primary outcome was defined as the first occurrence of ischemic stroke, transient ischemic attack (TIA), intracranial bleeding, gastrointestinal bleeding, hospitalization, or death. Chi-squared test was used to study categorical variables. Poisson regression was used to examine the effect of gender on outpatient visits per year, adjusted for comorbidities. 2592 patients were included in this study, 35.1% of whom were females. Female patients were younger (62.2 vs 63.3 years p <0.001), had less coronary artery disease (OR=0.68, p <0.001), and less chronic kidney disease (OR=0.89, p=0.005), but a more frequent stroke history (OR=1.4, p<0.001) at baseline (figure). Females were less likely to receive antiarrhythmic drug therapy (AAD) (OR=0.75, p=0.018). Among those who received AADs, female patients were less likely to receive amiodarone (OR=0.69, p=0.003), and more likely to receive flecainide (OR=3.45, p=0.048). Patients with at least 1 non-gender CHA2DS2-VASc risk factor had similar odds of receiving oral anticoagulation in general, and similar odds for receiving direct oral anticoagulants in particular. Females had one more outpatient visit per year than males did, even after accounting for comorbidity differences (p <0.001). Female patients had higher odds of achieving our primary outcome of stroke, TIA, intracranial bleeding, gastrointestinal bleeding, hospitalization, or death (OR=1.19, p=0.041). Female atrial fibrillation patients have a different comorbidity profile than their male counterparts. We found persistent gender disparities in the management and prognosis of atrial fibrillation in a modern Louisiana population.