Bisson A, et al. - This study entails comparison of gender-related differences in items from CHA₂DS₂-VASc score and their association with atrial fibrillation (AF) occurrence after ischemic stroke (IS). Findings demonstrated that between men and women, significant differences were noted in terms of comorbidities, possible mechanisms, incidence and predictors of AF. However, both genders were benefitted by a strategy that used CHA₂DS₂-VASc score for detecting a higher risk of incident AF following IS.

Methods

• This French cohort study was based on the database covering hospital care from 2009 to 2012 for the entire population.

Results

• This stduy included a total of 336,291 patients with IS, of these, 240,459 (71.5%) had no AF at baseline.
• Findings demonstrated that women were older, more frequently had hypertension, heart failure, and had a higher CHA₂DS₂-VASc score than men (4.63 vs 4.39, p<0.0001, after excluding the female gender component).
• In women vs men, the reported annual incidence of AF after IS was higher (9.8 vs 8.2%/year, p<0.0001).
• Except diabetes and vascular disease, incident AF was independently predicted by CHA₂DS₂-VASc score items.
• Men and women exhibited similar results when one analyzed separately these predictors except for vascular disease (associated with a lower risk of AF in women but not in men).
• In men (C statistic 0.720, 95%CI 0.717-0.722) vs women (0.702, 95%CI 0.699-0.704), somewhat higher predictive value of the CHA₂DS₂-VASc score was reported for identifying patients at higher risk of incident AF.
• Independent predictors of incident AF also included coronary artery disease, valvular disease and history of pacemaker/defibrillator implantation.