BMJ: AF as risk factor for cardiovasc... - Atrial Fibrillati...
BMJ: AF as risk factor for cardiovascular disease and death in women compared with men: systematic review and meta-analysis
This study shows that AF is associated with a higher mortality - 50% higher in men, 70% higher in women - compared with not having AF.
There are 3 explanations:
1) AF kills you
- it doesn't (well hardly ever) but its treatment possibly could.
2) AF causes something which kills you
- yes, strokes or bleeding from anticoagulant treatment
3) Something else causes AF AND kills you
- yes: old (biological) age, heart valve and muscle disease, hypertension, vascular disease, diabetes, obesity, chest disease... to mention but a few.
Why the association is stronger for women than men is not clear. The authors don't think it is because of different treatment. It could be just that more men die from non-AF-related illness (e.g. sudden heart attacks). Anyway, my interpretation of the results is (related to the explanations, above):
1) Assess the risk of the treatments carefully as AF is, in itself, a non-risky condition and balance this with the quality-of-life benefit.
2) Take anticoagulant treatment very seriously as this is the area of highest risk (both clotting and bleeding).
3) Look for the CAUSES for the AF as these are more likely to kill you - and treat them where possible.
