TY  -  JOUR
AU  -  Ferroni, Eliana
AU  -  Gennaro, Nicola
AU  -  Carbini, Giulia
AU  -  Pengo, Vittorio
AU  -  Zorzi, Manuel
T1  -  Sex differences in oral anticoagulants persistence among patients with non-valvular atrial fibrillation
PY  -  2024
Y1  -  2024-01-01
DO  -  10.1723/4235.42100
JO  -  Journal of Sex- and Gender-Specific Medicine
JA  -  J Sex Gender Specif Med
VL  -  10
IS  -  1
SP  -  4
EP  -  11
PB  -  Il Pensiero Scientifico Editore
SN  -  2974-8623
Y2  -  2026/04/30
UR  -  http://dx.doi.org/10.1723/4235.42100
N2  -  Summary. Direct-acting oral anticoagulants (DOACs) represent an effective treatment for non-valvular atrial fibrillation (NVAF) stroke prevention and non-persistence with anticoagulation therapy is significantly associated with worse clinical outcomes of stroke/transient ischemic attack (TIA)/death. Female patients are considered at risk of poor adherence and persistence to chronic treatments. We performed a population-based analysis, using healthcare databases of the Veneto Region, with the aim of analyzing the predictors of DOACs non-persistence in males and females with NVAF. We included subjects who had DOACs prescriptions in the period July 2013 - September 2017. We assessed one year persistence rate stratifying patients by sex. Multivariate Cox proportional hazard models were used to assess factors significantly associated with DOACs persistence. Study cohort included 17,920 patients, of whom 8,638 (49%) were males. Most patients (84.8%) were older than 64 years.DOACs persistence rate at one year was similar between sexes (around 73%). Sex differences emerged in the oldest age class (85+ years), where the persistence rate was 79% (76.1-81.2) in males and 75% (72.6-76.4) in females. Patients with younger age and renal disease showed worse persistence in both sexes. Previous bleeding significantly reduced persistence in females, but not in males. No sex differences were observed in the impact of previous stroke in increasing persistence, while previous acute myocardial infarction (AMI) had a significant impact on increasing persistence only in males. Further studies are needed to better understand the low anticoagulants persistence in older females.
ER  -