{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,16]],"date-time":"2025-11-16T18:31:37Z","timestamp":1763317897012,"version":"3.45.0"},"reference-count":36,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,12,1]],"date-time":"2024-12-01T00:00:00Z","timestamp":1733011200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100014741","name":"Cardiological Society of India","doi-asserted-by":"publisher","award":["CSI\/IEC\/2017"],"award-info":[{"award-number":["CSI\/IEC\/2017"]}],"id":[{"id":"10.13039\/501100014741","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Arrhythmia"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Much data informing sex differences in atrial fibrillation (AF) comes from Western cohorts. In this analysis, we describe sex differences in Kerala, India, using the Kerala\u2010AF registry\u2014the largest AF registry from the Indian subcontinent.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients aged \u226518\u2009years were recruited from 53 hospitals across Kerala. Patients were compared for demographics, treatments, and 12\u2010month outcomes, including major adverse cardiovascular events (MACE) and bleeding.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Male patients were more likely to have a smoking and\/or alcohol history and had more ischaemic heart disease (46.2% vs. 25.5%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Female patients had more valvular AF (35.1% vs. 18.0%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and more use of calcium\u2010channel blockers (23.3% vs. 16.5%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) or digoxin (39.6% vs. 28.5%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Almost one in four patients were not anticoagulated despite raised CHA\n                      <jats:sub>2<\/jats:sub>\n                      DS\n                      <jats:sub>2<\/jats:sub>\n                      \u2010VASc scores. 12\u2010month MACE outcomes did not differ by sex (male: 30.2% vs. female: 29.4%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.685), though bleeding events were more common in male patients (2.4% vs. 1.3%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009\u22120.038), driven by minor bleeding (1.2% vs. 0.5%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this large AF cohort from India, male patients had a higher prevalence of ischaemic heart disease, smoking, and alcohol use, while female patients had a higher prevalence of valvular heart disease. MACE did not differ by sex, though bleeding was more common in males. Almost a quarter of patients were not anticoagulated despite raised thromboembolic risk.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/joa3.13195","type":"journal-article","created":{"date-parts":[[2024,12,1]],"date-time":"2024-12-01T06:49:31Z","timestamp":1733035771000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Sex differences in atrial fibrillation in India: Insights from the Kerala\u2010\n                    <scp>AF<\/scp>\n                    registry"],"prefix":"10.1002","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8401-4033","authenticated-orcid":false,"given":"Peter","family":"Calvert","sequence":"first","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University, and Liverpool Heart and Chest Hospital  Liverpool UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yang","family":"Chen","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University, and Liverpool Heart and Chest Hospital  Liverpool UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ying","family":"Gue","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University, and Liverpool Heart and Chest Hospital  Liverpool UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3490-090X","authenticated-orcid":false,"given":"Dhiraj","family":"Gupta","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University, and Liverpool Heart and Chest Hospital  Liverpool UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jinbert Lordson","family":"Azariah","sequence":"additional","affiliation":[{"name":"Department of Clinical Research Ananthapuri Hospitals and Research Institute  Thiruvananthapuram India"},{"name":"Department of Research Global Institute of Public Health  Trivandrum India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"George Koshy","sequence":"additional","affiliation":[{"name":"Cosmopolitan Hospital  Trivandrum Kerala India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Geevar","family":"Zachariah","sequence":"additional","affiliation":[{"name":"Mother Hospital  Thrissur Kerala India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K. U.","family":"Natarajan","sequence":"additional","affiliation":[{"name":"Amrita Institute of Medical Sciences  Kochi Kerala India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7566-1626","authenticated-orcid":false,"given":"Gregory Y. 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