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Journal article

Atrial fibrillation as risk factor for cardiovascular disease and death in women compared with men: systematic review and meta-analysis of cohort studies.

Abstract:

Objective

To determine whether atrial fibrillation is a stronger risk factor for cardiovascular disease and death in women compared with men.

Design

Meta-analysis of cohort studies.

Data Sources

Studies published between January 1966 and March 2015, identified through a systematic search of Medline and Embase and review of references.

Eligibility for Selecting Studies

Cohort studies with a minimum of 50 participants with and 50 without atrial fibrillation that reported sex specific associations between atrial fibrillation and all cause mortality, cardiovascular mortality, stroke, cardiac events (cardiac death and non-fatal myocardial infarction), and heart failure.

Data Extraction

Two independent reviewers extracted study characteristics and maximally adjusted sex specific relative risks. Inverse variance weighted random effects meta-analysis was used to pool sex specific relative risks and their ratio.

Results

30 studies with 4 371 714 participants were identified. Atrial fibrillation was associated with a higher risk of all cause mortality in women (ratio of relative risks for women compared with men 1.12, 95% confidence interval 1.07 to 1.17) and a significantly stronger risk of stroke (1.99, 1.46 to 2.71), cardiovascular mortality (1.93, 1.44 to 2.60), cardiac events (1.55, 1.15 to 2.08), and heart failure (1.16, 1.07 to 1.27). Results were broadly consistent in sensitivity analyses.

Conclusion

Atrial fibrillation is a stronger risk factor for cardiovascular disease and death in women compared with men, though further research would be needed to determine any causality.

Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1136/bmj.h7013

Authors


More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Nuffield Department of Population Health
Sub department:
Population Health
Role:
Author
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
NDORMS
Sub department:
Centre for Statistics in Medicine
Role:
Author
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Women's and Reproductive Health
Role:
Author


Publisher:
BMJ Publishing Group
Journal:
BMJ (Clinical research ed.) More from this journal
Volume:
532
Pages:
h7013
Publication date:
2016-01-01
DOI:
EISSN:
1756-1833
ISSN:
0959-8138


Language:
English
Pubs id:
pubs:597887
UUID:
uuid:4c339f87-2f2d-44d5-ae9b-9849d513eb7a
Local pid:
pubs:597887
Source identifiers:
597887
Deposit date:
2016-02-23

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