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Curr Treat Options Cardiovasc Med. 2018 Aug 27;20(10):79. doi: 10.1007/s11936-018-0682-3.

Sex Differences in Atrial Fibrillation-Update on Risk Assessment, Treatment, and Long-Term Risk.

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Rush Heart Center for Women, 1725 W. Harrison St. Suite 1159, Chicago, IL, 60612-3864, USA.
Rush University Medical Center, 1717 W. Congress Pkwy, Suite 317 Kellogg, Chicago, IL, 606012, USA.
King Abdul-Aziz University, Jeddah, Saudi Arabia.
Rush Alzheimer's Disease Center, Rush Heart Center for Women, 1725 Harrison St. Suite 1159, Chicago, IL, 60612, USA.
Rush Heart Center for Women, 1725 W. Harrison St. Suite 1159, Chicago, IL, 60612-3864, USA.



Atrial fibrillation (AF) is a growing health problem worldwide. While the disease plagues both men and women, this arrhythmia does not affect both sexes equally. Women are more likely to have major adverse outcomes such as stroke and its sequela; however, recent data on stroke prevention show improving outcomes. The purpose of this review of the recent literature is to summarize important updates on risk scores and management of patients with AF.


It has been well known that women have a higher risk of strokes than men when untreated or when treated with warfarin. Current risk scores emphasizing new risk factors such as the higher risk of strokes in women have been incorporated into clinical guidelines. However, with the use of direct oral anticoagulants, this sex disparity on stroke is no longer seen and women have less major bleeding than men. The use of cardiac glycosides is associated with increased incidence of breast cancer, and this medication is used more in women. Procedural complications for the management of AF are higher in women. The study of the pathophysiology of AF and its management is a rapidly evolving area of cardiovascular medicine. Sex-specific data is necessary to achieve advances in the field and improve the outcomes in both men and women.


Atrial fibrillation; Cardiovascular disease in women; Stroke prevention


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