{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T16:56:05Z","timestamp":1755795365532,"version":"3.44.0"},"reference-count":35,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2024,8,12]],"date-time":"2024-08-12T00:00:00Z","timestamp":1723420800000},"content-version":"unspecified","delay-in-days":11,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Pfizer\/Bristol\u2010Myers Squibb"},{"name":"Foundation for Cardiovascular Research Basel"},{"DOI":"10.13039\/100004326","name":"Bayer","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004326","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Daiichi\u2010Sankyo"},{"DOI":"10.13039\/501100008485","name":"Schweizerische Akademie der Medizinischen Wissenschaften","doi-asserted-by":"publisher","award":["Young Talents in Clinical Research grant"],"award-info":[{"award-number":["Young Talents in Clinical Research grant"]}],"id":[{"id":"10.13039\/501100008485","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001711","name":"Schweizerischer Nationalfonds zur F\u00f6rderung der Wissenschaftlichen Forschung","doi-asserted-by":"publisher","award":["32003B_197524","32473B_176178","33CS30_148474","33CS30_177520","PP00P3_159322"],"award-info":[{"award-number":["32003B_197524","32473B_176178","33CS30_148474","33CS30_177520","PP00P3_159322"]}],"id":[{"id":"10.13039\/501100001711","id-type":"DOI","asserted-by":"publisher"}]},{"name":"McMaster University Department of Medicine","award":["Mid-career award"],"award-info":[{"award-number":["Mid-career award"]}]},{"name":"Hamilton Health Sciences RFA Strategic Initiative Program"},{"DOI":"10.13039\/100008375","name":"University of Basel","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100008375","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100002129","name":"Heart Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100002129","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Merck Sharp & Dome"},{"DOI":"10.13039\/100004339","name":"Sanofi\u2010Aventis","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100004339","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100001003","name":"Boehringer Ingelheim","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001003","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"accepted":{"date-parts":[[2024,7,19]]},"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Sex differences occur in atrial fibrillation (AF), including age at first manifestation, pathophysiology, treatment allocation, complication rates and quality of life. However, optimal doses of cardiovascular pharmacotherapy used in women with AF with or without heart failure (HF) are unclear. We investigated sex-specific associations of beta-blocker and renin\u2013angiotensin system (RAS) inhibitor doses with cardiovascular outcomes in patients with AF or AF with concomitant HF.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We used data from the prospective Basel Atrial Fibrillation and Swiss Atrial Fibrillation cohorts on patients with AF. The outcome was major adverse cardiovascular events (MACEs), including death, myocardial infarction, stroke, systemic embolisation and HF-related hospitalisation. Predictors of interest were spline (primary analysis) or quartiles (secondary analysis) of beta-blocker or RAS inhibitor dose in per cent of the maximum dose (reference), in interaction with sex. Cox models were adjusted for demographics, comorbidities and comedication.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among 3961 patients (28%\u2009women), MACEs occurred in 1113 (28%) patients over a 5-year median follow-up. Distributions of RAS inhibitor and beta-blocker doses were similar in women and men. Cox models revealed no association between beta-blocker dose or RAS inhibitor dose and MACE. In a subgroup of patients with AF and HF, the lowest hazard of MACE was observed in women prescribed 100% of the RAS inhibitor dose. However, there was no association between RAS dose quartiles and MACE.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>In this study of patients with AF, doses of beta-blockers and RAS inhibitors did not differ by sex and were not associated with MACE overall.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/openhrt-2024-002720","type":"journal-article","created":{"date-parts":[[2024,8,12]],"date-time":"2024-08-12T08:07:41Z","timestamp":1723450061000},"page":"e002720","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Sex-specific association of cardiovascular drug doses with adverse outcomes in atrial fibrillation"],"prefix":"10.1136","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8286-618X","authenticated-orcid":false,"given":"Jeanne","family":"Moor","sequence":"first","affiliation":[{"name":"Department of General Internal Medicine, Inselspital University Hospital Bern, Bern, Switzerland"},{"name":"Institute of Primary Health Care, University of Bern, Bern, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Kuhne","sequence":"additional","affiliation":[{"name":"Cardiology Division, Department of Medicine, University Hospital Basel, Basel, Switzerland"},{"name":"Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4043-8061","authenticated-orcid":false,"given":"Giorgio","family":"Moschovitis","sequence":"additional","affiliation":[{"name":"Cardiology Regional Hospital of Lugano, Cardiocentro Ticino, Lugano, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Kobza","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Luzerner Kantonsspital, Luzern, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seraina","family":"Netzer","sequence":"additional","affiliation":[{"name":"Department of General Internal Medicine, Inselspital University Hospital Bern, Bern, Switzerland"},{"name":"Institute of Primary Health Care, University of Bern, Bern, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angelo","family":"Auricchio","sequence":"additional","affiliation":[{"name":"Cardiology Regional Hospital of Lugano, Cardiocentro Ticino, Lugano, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juerg H","family":"Beer","sequence":"additional","affiliation":[{"name":"Department of Medicine, Baden Cantonal Hospital, Baden, Switzerland"},{"name":"Center for Molecular Cardiology, University of Zurich, Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leo","family":"Bonati","sequence":"additional","affiliation":[{"name":"Research Department, Reha Rheinfelden, Rheinfelden, Switzerland"},{"name":"Department of Neurology, University Hospital Basel, Basel, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tobias","family":"Reichlin","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Inselspital University Hospital Bern, Bern, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Conen","sequence":"additional","affiliation":[{"name":"Department of Medicine, McMaster University, Hamilton, Ontario, Canada"},{"name":"Population Health Research Institute, Hamilton, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"Osswald","sequence":"additional","affiliation":[{"name":"Cardiology Division, Department of Medicine, University Hospital Basel, Basel, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicolas","family":"Rodondi","sequence":"additional","affiliation":[{"name":"Department of General Internal Medicine, Inselspital University Hospital Bern, Bern, Switzerland"},{"name":"Institute of Primary Health Care, University of Bern, Bern, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carole","family":"Clair","sequence":"additional","affiliation":[{"name":"Department of Ambulatory Care, University of Lausanne, Lausanne, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christine","family":"Baumgartner","sequence":"additional","affiliation":[{"name":"Department of General Internal Medicine, Inselspital University Hospital Bern, 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