Abstract 13658: Impact of Risk Factors for Atrial Fibrillation on the Incidence of Stroke in African American Females

Abstract

Background: It is well-known that African American (AA) patients with Atrial Fibrillation (AF) have a higher incidence of stroke in comparison to the general population. To our knowledge, limited data exist on gender disparities in risk factors contributing to a higher incidence of stroke among AA patients. The objective of this study is to identify gender disparities in risk factors for AF by comparing AA females and males with AF. Methods: AA patients aged 18 years old or above with a diagnosis of AF were included in this study. Patients were selected from the 2019 national inpatient sample. The primary outcome of interest was incidence of stroke. T-test was used to compare differences in continuous variables. For categorical variables, pearson chi-square was used to compare differences. Multivariate logistic regression was used to adjust for potential confounders. A 2-sided P<0.05 was considered significant throughout the analyses. Results: This study included 45,102 AA female patients with AF, and 46,768 AA male patients with AF. In our study, female patients had higher prevalence of Hypertension (HTN) (22.3% vs 19.0, P<0.001), Diabetes Mellitus (DM) (48.1 vs 46.0, P<0.001), Obesity (27.8 vs 20.8), Hyperlipidemia (HLD) (50.9% vs 49.1%, P<0.001), Hyperthyroidism (2.2% vs 1.2%, P<0.001), and Chronic Obstructive Pulmonary Disease (COPD) (24.8% vs 23.2%, P<0.001). AA female patients with AF experienced higher incidence of stroke compared to AA male patients with AF, (4.9% vs 4.1%, p-value <0.001) and the odds of stroke also showed higher in female patients (aOR=1.10, 95% CI: 1.03-1.18, p <0.005) after controlling for comorbidities. Only HTN and HLD showed statistically significant association with stroke in univariate analysis, (OR=2.02, 95% CI: 1.89-2.16 and OR=1.24, 95% CI:1.16-1.31, respectively) Conclusion: In our study, we identified that AA female patients with AF had a higher incidence of stroke compared to AA male patients with AF. Only HTN and HLD were significant risk factors contributing to the increased stroke incidence in the female group. The findings of our study are hypothesis-generating, and well-powered randomized controlled trials are needed to validate these findings.