BackgroundAtrial Fibrillation (AF) is associated with an increased risk of stroke and systemic embolism. Several studies have suggested that female AF patients could have a greater risk for stroke. There is scarce information about clinical characteristics and use of antithrombotic therapies in Latin American patients with nonvalvular AF.ObjectiveTo describe the gender differences in clinical characteristics, thromboembolic risk, and antithrombotic therapy of patients with nonvalvular AF recruited in Mexico, an upper middle-income country, into the prospective national CARMEN-AF Registry.MethodsA total of 1423 consecutive patients, with at least one thromboembolic risk factor were enrolled in CARMEN-AF Registry during a three-year period (2014–2017). They were categorized according to Gender.ResultsOverall, 48.6% were women, mean age 70 ± 12 years. Diabetes, smoking, alcoholism, non-ischemic cardiomyopathy, coronary artery disease, and obstructive sleep apnea were higher in men. Most women were found with paroxysmal AF (40.6%), and most men with permanent AF (44.0%). No gender differences were found in the use of vitamin K antagonists (VKA) (30.5% in women vs. 28.0% in men). No gender differences were found in the use of direct oral anticoagulants (DOAC) (33.8% women vs 35.4% men).ConclusionsCARMEN-AF Registry demonstrates that in Mexico, regardless of gender, a large proportion of patients remain undertreated. No gender differences were found in the use of VKA or DOAC.
El presente trabajo examina las consecuencias de la prolongada militarización de la seguridad pública y de la sostenida expansión de los roles y prerrogativas de las fuerzas armadas en América Latina, y propone que la región ha ingresado en una etapa de creciente militarismo civil. Enfrentadas a una crisis de seguridad pública y a Estados débiles, las élites políticas de la mayor parte de las democracias latinoamericanas han optado por la militarización del policiamiento debido a la mejor aprobación de las fuerzas armadas, a pesar de su escaso —y a veces contraproducente— impacto en la seguridad pública. Se trata de una estrategia política para obtener o mantener el poder a partir de la naturalización de la militarización. En una cantidad importante de países el militarismo civil está desplazando la gobernanza del policiamiento y de la relación civil militar, desde un eje democrático hacia otro híbrido y, en algunos casos, autoritario. Ello contribuye a la erosión de las democracias latinoamericanas mediante su deslegitimación, y el debilitamiento del control civil y del Estado de derecho. El militarismo civil puede constituir un preludio y un camino a través del cual los países de la región transiten hacia nuevas regresiones democráticas.
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