Young-onset atrial fibrillation: Sex differences in clinical profile, progression rate and cardiovascular outcome.

BACKGROUND: Women are underrepresented in major atrial fibrillation (AF) trials. In addition, data regarding clinical profile and outcome in young AF patients is limited. Therefore we aimed to investigate the clinical profile, AF progression rate and cardiovascular outcome between sexes in patients with young-onset AF. METHODS: A total of 497 patients with AF-onset <60 years of age were included. Data on clinical profile and cardiovascular outcome were prospectively collected. RESULTS: Of 497 patients, 125 (25%) patients were women. Women had more often familial AF (34% versus 22%, P = 0.012) and obesity (26% versus 18%, P = 0.03). Men had more often coronary artery disease (11% versus 5%, P = 0.04), a longer PR interval [163 (148-180) versus 150 (138-167) ms, P < 0.001] and higher left ventricular mass index [82 (71-96) versus 72 (61-83) g/m2, P < 0.001]. During a median follow-up of 7.0 (2.7-10.0) years AF progression rate was comparable (HR 2.03 for men versus women, 95%CI 0.92-4.48; P = 0.08), and no difference in cardiovascular events was observed between women and men (Log rank P-value = 0.07). CONCLUSIONS: In young patients with AF, clinical patient profile is different between the sexes but did not result in differences in cardiovascular outcome.