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Death rate higher in women after discharge for heart arrhythmias

More deaths occurred among female patients with atrial fibrillation/flutter after discharge from emergency departments

Ingrid Torjesen

Thursday, 04 May 2017

Women who present to emergency departments with atrial fibrillation and flutter (AFF) are more likely to die within 90 days of discharge than men, shows a study* published in the Canadian Journal of Cardiology.

The researchers examined differences in outcomes for 21,062 patients (47.5% of whom were women) who presented with AFF to emergency departments across Alberta, Canada. They extracted anonymised data from linked provincial databases for all patients who had been discharged from the emergency department after presenting for AFF from 1999 to 2011.

The results showed that women experienced higher death rates than men at 30 and 90 days after discharge. Within 30 days of discharge, 234 patients had died (1.3% female vs 0.9% male). Of these, 6.0%, 6.8%, and 5.6% of deaths were reported as AFF, heart failure, and stroke related, respectively. Within 90 days of discharge, there were 548 deaths (2.9% female vs 2.4% male). Of these deaths, 4.6%, 5.3%, and 4.6% were reported as AFF, heart failure, and stroke related, respectively, and there were more deaths following stroke for woman than men.

The prevalence of AFF increases with age. Rates are 5.9% in men and 2.8% in women 65-69 years of age, increasing to 8.0% in men and 6.7% in women aged 80 years and older. The number of people with AFF is expected to rise substantially as life expectancy increases.

Lead investigator Rhonda Rosychuk, Professor of paediatrics at the Department of Paediatrics, University of Alberta and the Women & Children's Health Research Institute, Edmonton, Alberta, Canada, said: "Women were more likely to be discharged from the emergency department than men for acute myocardial infarction, unstable angina, stable angina, and chest pain. However, there are few data on the epidemiology of AFF in the emergency department setting, and sex differences are not well understood."

She added: "Emergency, family medicine, and specialist clinician groups should be aware of the sex-based differences we have identified and ensure similar evidence-based management is provided to both men and women to improve health outcomes."

* Rosychuk RJ, Holroyd BR, Zhang X, et al. Sex Differences in Outcomes After Discharge from the Emergency Department for Atrial Fibrillation/Flutter. Canadian Journal of Cardiology, 2017. DOI: 10.1016/j.cjca.2017.02.002

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