Atrial fibrillation affects both men and women but the characteristics between them are different. However women are in general underrepresented in trials and there is lack of data regarding sex-differences. Mariëlle Kloosterman, Michiel Rienstra and Isabelle van Gelder explored sex differences in risk factors, cardiovascular events and quality of life as a post hoc analysis in the RACE II study.
RACE II was a randomized, multicentre study comparing long-term effects of lenient vs. strict rate control perfomed in the Netherlands between 2005 and 2007 including 614 patients with permanent AF and was published in the New England Journal of Medicine in 2010. In this analysis, the authors showed that women with permanent AF had more accumulation of AF risk factors than men. In addition, quality of life was negatively influenced by the higher number of risk factors in women. This suggests that focusing on underlying risk factor burden may provide plausible mechanical and biological basis to better understand the sex related differences in patients with AF.