Sex differences in treatment strategy and adverse outcomes among patients 75 and older with atrial fibrillation in the MarketScan database

Table 4 Association of Direct oral anticoagulant use (vs. warfarin) after atrial fibrillation diagnosis with cardiovascular events, by sex, among elderly participants in the MarketScan database (2007–2015)

Outcome	Men				Women				p value for multiplicative interaction	ICR
	Model 1^†		Model 2^††		Model 1^†		Model 2^††
	Warfarin	DOAC	Warfarin	DOAC	Warfarin	DOAC	Warfarin	DOAC
Heart failure
Events/N	4799/54,192	355/8461	4799/54,192	355/8461	4149/49,845	312/8130	4149/49,845	312/8130	0.89	0.02
HR (95% CI)	1 (ref.)	0.81 (0.73, 0.91)	1 (ref.)	0.94 (0.84, 1.05)	1 (ref.)	0.82 (0.73, 0.92)	1 (ref.)	0.93 (0.83, 1.04)
Stroke
Events/N	1328/54,411	93/8487	1328/54,411	93/8487	1766/50,031	140/8155	1766/50,031	140/8155	0.3	0.119
HR (95% CI)	1 (ref.)	0.85 (0.69, 1.05)	1 (ref.)	0.89 (0.72, 1.10)	1 (ref.)	1.00 (0.84, 1.19)	1 (ref.)	1.01 (0.86, 1.22)
Major bleeding
Events/N	3390/54,315	286/8481	3390/54,315	286/8481	3066/49,981	273/8144	3066/49,981	273/8144	0.56	0.063
HR (95% CI)	1 (ref.)	0.99 (0.88, 1.12)	1 (ref.)	1.01 (0.89, 1.14)	1 (ref.)	0.99 (0.87, 1.12)	1 (ref.)	1.03 (0.90, 1.16)

HR hazard ratio, CI confidence interval, ICR interaction contrast ratio
Bolded results are statistically significant at p value of 0.05
^†Model 1 adjusts for age
^††Model 2 adjusts for age plus heart failure, hypertension, diabetes mellitus, stroke, myocardial infarction, peripheral arterial disease, chronic kidney disease, gastrointestinal bleed, liver disease, hyperlipidemia, chronic obstructive pulmonary disease, depression, dementia, intracranial bleeding, other forms of bleeding, alcohol abuse, use of lipid lowering medication, beta blockers, calcium channel blockers, angiotensin receptor blocker, angiotensin converting enzyme inhibitor, diuretics, gastrointestinal drugs, cardiac drugs, potassium supplements, anti-diabetics, anti-platelet drugs, thiazide diuretics, anti-arrhythmics, insulin, sulphonylureas, other diuretics, statins and digoxin

ISSN: 1471-2261