{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T04:31:10Z","timestamp":1790397070833,"version":"4.1.0"},"reference-count":51,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2021,2,18]],"date-time":"2021-02-18T00:00:00Z","timestamp":1613606400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Pfizer Israel","award":["B0661099"],"award-info":[{"award-number":["B0661099"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Introduction<\/jats:title>\n<jats:p>Atrial fibrillation (AF) is a major increasing public health problem worldwide, with clinical and epidemiological differences between men and women. However, contemporary population-level data on incidence and survival are scarce.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Aim<\/jats:title>\n<jats:p>To evaluate sex-specific contemporary trends in the incidence, prevalence, and long-term survival of non-valvular AF in a real-world setting<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Methods<\/jats:title>\n<jats:p>AF patients diagnosed between 2007\u20132015, insured by a large, state-mandated health organization in Israel (Maccabi Healthcare Services) were included. AF was diagnosed based on registered diagnoses. Patients with valvular disease, active malignancy, cardiac surgery \u2264 6 months, or recent pregnancy, were excluded. Annual incidence rate, period prevalence, and 5-year survival for each calendar year during the study period, were calculated.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Results<\/jats:title>\n<jats:p>A total of 15,409 eligible patients (8,288 males, 7,121 females) were identified. Males were more likely to be younger, have higher rates of underlying diseases (ischemic heart disease, heart failure, and chronic obstructive pulmonary disease), but with lower rates of hypertension and chronic kidney diseases as compared to female patients. During the study period, age-adjusted incidence decreased both in men: (-0.020\/1,000-person year, p-for trend = 0.033) and, women (-0.025\/1,000 person-year p = 0.009). The five-year survival rate was significantly higher among men vs. women (77.1% vs. 71.5%, respectively, p&lt;0.001). Age-adjusted prevalence increased significantly among men (+0.102 per year, p-for trend&lt;0.001) yet decreased among women (-0.082 per year, p-for trend = 0.005). A significant trend toward improved long-term survival was observed in women and not in men.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec005\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>The current study shows significant sex-related disparities in the incidence, prevalence, and survival of AF patients between 2007\u20132015; while the adjusted incidence of both has decreased over-time, prevalence and mortality decreased significantly only in women.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0247097","type":"journal-article","created":{"date-parts":[[2021,2,18]],"date-time":"2021-02-18T19:19:06Z","timestamp":1613675946000},"page":"e0247097","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":12,"title":["Sex-specific contemporary trends in incidence, prevalence and survival of patients with non-valvular atrial fibrillation: A long-term real-world data 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Kamalvand","year":"1999","journal-title":"European heart journal"},{"issue":"6","key":"pone.0247097.ref040","doi-asserted-by":"crossref","first-page":"1471","DOI":"10.1161\/01.CIR.94.6.1471","article-title":"Sex hormones prolong the QT interval and downregulate potassium channel expression in the rabbit heart","volume":"94","author":"MD Drici","year":"1996","journal-title":"Circulation"},{"issue":"1","key":"pone.0247097.ref041","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/S0898-6568(99)00066-2","article-title":"Acute modulation of Ca2+ influx on rat heart by 17beta-estradiol","volume":"12","author":"C Buitrago","year":"2000","journal-title":"Cellular signalling"},{"issue":"5","key":"pone.0247097.ref042","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1111\/jce.12651","article-title":"Age, atrial fibrillation, and structural heart disease are the main determinants of left atrial fibrosis detected by delayed-enhanced magnetic resonance imaging in a general 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