Gender differences in comorbidities and risk factors in ischemic stroke patients with a history of atrial fibrillation

Abstract

Background Atrial Fibrillation (AF) is a common cardiac arrhythmia and has been identified as a major risk factor for acute ischemic stroke (AIS). Gender differences in the disease process, causative mechanisms and outcomes of AF have been investigated. In the current study, we determined whether there is a gender-based disparity in AIS patients with baseline AF, and whether such a discrepancy is associated with specific risk factors and comorbidities. Methods Baseline factors including comorbidities, risk and demographic factors associated with a gender difference were examined using retrospective data collected from a registry from January 2010 to June 2016 in a regional stroke center. Univariate analysis was used to differentiate between genders in terms of clinical risk factors and demographics. Variables in the univariate analysis were further analyzed using logistic regression. The adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for each factor were used to predict the increasing odds of an association of a specific comorbidity and risk factor with the male or female AIS with AF. Results In the population of AIS patients with AF, a history of drug and alcohol use (OR = 0.250, 95% CI, 0.497–1.006, P = 0.016), sleep apnea (OR = 0.321, 95% CI, 0.133–0.777, P = 0.012), and higher serum creatinine (OR = 0.693, 95% CI, 0.542–0.886 P = 0.003) levels were found to be significantly associated with the male gender. Higher levels of HDL-cholesterol (OR = 1.035, 95% CI, 1.020–1.050, P < 0.001), LDL-cholesterol (OR = 1.006, 95% CI, 1.001–1.011, P = 0.012), and the inability to ambulate on admission to hospital (OR = 2.258, 95% CI, 1.368–3.727, P = 0.001) were associated with females. Conclusion Our findings reveal that in the AIS patients with atrial fibrillation, migraines, HDL, LDL and poor ambulation were associated with females, while drugs and alcohol, sleep apnea, and serum creatinine level were associated with male AIS patients with AF. Further studies are necessary to determine whether gender differences in risk factor profiles and commodities require consideration in clinical practice when it comes to AF as a risk factor management in AIS patients.

The prevalence of atrial fibrillation in Greenland: a register-based cross-sectional study based on disease classifications and prescriptions of oral anticoagulants

“…In addition, we found that the women in our study had a higher prevalence of stroke than men. Generally, women older than 65 years with AF have a higher rate of ischaemic strokes than men with AF [ 29 , 39 , 40 ], and our results may indicate that women in Greenland more often suffer a stroke before being diagnosed with AF.…”

Acute Ischemic Stroke and Heart Failure: Stroke Risk Factors Associated with Exclusion from Thrombolytic Therapy

“…Similar findings have been reported for AIS patients with histories of previous TIA, [21][22][23] elevated cholesterol levels, 13,24 and direct admission. 25,26 We also observed that AIS patients without HF who did not receive rtPA were more likely to be Hispanic and present with coronary artery stenosis, previous stroke, and elevated lipid level, creatinine, INR, and heart rate. Our finding that Hispanic AIS patients without HF were more likely not to be treated with rtPA is supported by prior studies showing lower rates of rtPA use among the Hispanic population.…”

Sex Differences in Stroke Risk Factors, Clinical Profiles, and In-Hospital Outcomes Among Stroke Patients Admitted to the Medical Ward of Dessie Comprehensive Specialized Hospital, Northeast Ethiopia

“…Nevertheless, the current study did not find any significant sex differences in the other stroke risk factors. Significant gender differences in stroke risk factors, such as hypertension, 15 , 43 , 44 atrial fibrillation, 44 , 49 dyslipidemia, and obesity, 43 , 44 have been reported in several studies. These are more common in women than in men.…”