• José L López-Sendón, David Alonso-Rodríguez, Gonzalo Barón-Esquivias, Juan Cosin-Sales, Francisco Marín, Jordi Galera-Llorca, Natalia Jiménez, Sabrina Marler, Menno V Huisman, LipGregory Y HGYHUniversity of Liverpool and Liverpool Heart & Chest, Thomas Dr, Liverpool L14 3PE, UK., and Spanish GLORIA-AF investigators.
• Hospital Universitario La Paz, IDIPAZ, CIBER-CV, Paseo de la Castellana 261, 28046 Madrid, Spain. Electronic address: jlopezsendon@gmail.com.
• Med Clin (Barc). 2022 Aug 26; 159 (4): 177-182.

Background And ObjectiveThromboembolic risk is higher in women than men with non-valvular atrial fibrillation (NVAF). Published data indicate variability in antithrombotic use by gender and region. We analyzed gender-specific antithrombotic treatment patterns in Spain and rest of Western Europe (rWE) in patients with NVAF.MethodsGLORIA-AF (Phase III) is a global, prospective, observational study which enrolled newly diagnosed NVAF patients with CHA2DS2-VAScs≥1 (2014-2016). Analyses were performed comparing antithrombotic treatments by gender in Spain and rWE.ResultsThis analysis included 1163 and 7972 patients from Spain and rWE, respectively. Stroke risk was higher in women than men in both Spain and rWE. While in rWE, bleeding risk and antithrombotic treatment pattern were similar between genders, in Spain bleeding risk in women was lower and more females compared to men received OACs (95.0% versus 92.4%, d=-0.1078, respectively). Fewer Spanish patients received direct oral anticoagulants (DOACs) (women 32.1%, men 25.3%) than vitamin-K-antagonists (VKAs) (women 63.0%, men 67.1%) vs. rWE patients. In Spain women received more DOACs compared to men (56.0% versus 44.0%).ConclusionsOAC rates were higher in Spain as compared to rWE. More women received OACs in Spain, while in rWE no difference by gender was observed. DOACs in rWE are the most prescribed OAC while in Spain, due to prescription barriers, its use remains low for both genders and VKAs are preferred. Spanish women received more DOACs compared to men. (NCT01468701).Copyright © 2021 The Authors. Published by Elsevier España, S.L.U. All rights reserved.

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