{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T14:47:52Z","timestamp":1768834072122,"version":"3.49.0"},"reference-count":40,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2025,2,11]],"date-time":"2025-02-11T00:00:00Z","timestamp":1739232000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"British Heart Foundation Programme","award":["RG\/17\/3\/32,774"],"award-info":[{"award-number":["RG\/17\/3\/32,774"]}]},{"name":"British Heart Foundation Programme","award":["MR\/S037306\/1"],"award-info":[{"award-number":["MR\/S037306\/1"]}]},{"name":"British Heart Foundation Programme","award":["NIHR204553"],"award-info":[{"award-number":["NIHR204553"]}]},{"name":"British Heart Foundation Programme","award":["NIHR203327"],"award-info":[{"award-number":["NIHR203327"]}]},{"name":"Medical Research Council Biomedical Catalyst Developmental Pathway Funding Scheme","award":["RG\/17\/3\/32,774"],"award-info":[{"award-number":["RG\/17\/3\/32,774"]}]},{"name":"Medical Research Council Biomedical Catalyst Developmental Pathway Funding Scheme","award":["MR\/S037306\/1"],"award-info":[{"award-number":["MR\/S037306\/1"]}]},{"name":"Medical Research Council Biomedical Catalyst Developmental Pathway Funding Scheme","award":["NIHR204553"],"award-info":[{"award-number":["NIHR204553"]}]},{"name":"Medical Research Council Biomedical Catalyst Developmental Pathway Funding Scheme","award":["NIHR203327"],"award-info":[{"award-number":["NIHR203327"]}]},{"name":"NIHR i4i","award":["RG\/17\/3\/32,774"],"award-info":[{"award-number":["RG\/17\/3\/32,774"]}]},{"name":"NIHR i4i","award":["MR\/S037306\/1"],"award-info":[{"award-number":["MR\/S037306\/1"]}]},{"name":"NIHR i4i","award":["NIHR204553"],"award-info":[{"award-number":["NIHR204553"]}]},{"name":"NIHR i4i","award":["NIHR203327"],"award-info":[{"award-number":["NIHR203327"]}]},{"name":"National Institute of Health Research","award":["RG\/17\/3\/32,774"],"award-info":[{"award-number":["RG\/17\/3\/32,774"]}]},{"name":"National Institute of Health Research","award":["MR\/S037306\/1"],"award-info":[{"award-number":["MR\/S037306\/1"]}]},{"name":"National Institute of Health Research","award":["NIHR204553"],"award-info":[{"award-number":["NIHR204553"]}]},{"name":"National Institute of Health Research","award":["NIHR203327"],"award-info":[{"award-number":["NIHR203327"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Disparities in the therapy and outcomes of males and females with atrial fibrillation (AF) are known in the developed world. Still, data regarding these disparities in the developing world are scarce. This study explores gender trends and outcomes in oral anticoagulation prescription during the Syrian conflict. Methods: We included adult patients with an index admission with AF to Latakia\u2019s tertiary centre between September 2021 and February 2024. Data regarding treatments and comorbidities were taken from patients\u2019 medical notes. The composite outcome was a readmission with a cerebrovascular event (CVA) or a bleeding event within 60 days of index discharge. A regression model was used to assess predictors of composite outcomes. Results: A total of 683 consecutive patients admitted and treated for AF satisfied the study criteria, of whom 347 (51%) were females. In patients with a guideline indication for anticoagulation (n = 553), males were prescribed more DOACs and fewer VKAs than females (93% versus 71%, p &lt; 0.001 and 7% versus 29%, p = 0.01, respectively). Composite outcomes occurred significantly more in females than males (16% versus 6%, p = 0.03). Females on VKAs had significantly more composite outcomes than males (70% versus 53%, p &lt; 0.001). Independent predictors of composite outcomes included females compared to males (hazard ratio [HR]: 2.3 and 6.2, 95% confidence interval [CI]: 1.3\u20134.2 and 3.7\u201310.8, p = 0.001 and &lt;0.001) and VKAs compared to direct oral anticoagulants (DOACs) (HR: 8.4, 95%CI: 4.8\u201315.3, p &lt; 0.001). Conclusions: Females at this Syrian centre had a higher use of VKAs and a lower use of DOACs compared to males, resulting in a higher rate of composite outcomes of CVA and bleeding events.<\/jats:p>","DOI":"10.3390\/jcm14041173","type":"journal-article","created":{"date-parts":[[2025,2,11]],"date-time":"2025-02-11T10:53:22Z","timestamp":1739271202000},"page":"1173","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Gender Disparity in Oral Anticoagulation Therapy in Hospitalised Patients with Atrial Fibrillation During the Ongoing Syrian Conflict: Unbalanced Treatment in Turbulent Times"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4374-7476","authenticated-orcid":false,"given":"Ibrahim","family":"Antoun","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Sciences, University of Leicester, Glenfield Hospital, Groby Road, Leicester LE3 9QP, UK"},{"name":"Faculty of Medicine, University of Aleppo, Aleppo P.O. Box 12212, Syria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alkassem","family":"Alkhayer","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Tishreen\u2019s Hospital, Latakia P.O. Box 2230, Syria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aref Jalal","family":"Eldin","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Tishreen\u2019s Hospital, Latakia P.O. Box 2230, Syria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alamer","family":"Alkhayer","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Tishreen\u2019s Hospital, Latakia P.O. Box 2230, Syria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khaled","family":"Yazji","sequence":"additional","affiliation":[{"name":"NIHR Leicester Biomedical Research Centre, Leicester LE3 9QP, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5162-3644","authenticated-orcid":false,"given":"Riyaz","family":"Somani","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences, University of Leicester, Glenfield Hospital, Groby Road, Leicester LE3 9QP, UK"},{"name":"Department of Cardiac Surgery, University Hospitals of Leicester NHS Trust, Glenfield Hospital, Leicester LE3 9QP, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5965-0671","authenticated-orcid":false,"given":"G. Andr\u00e9","family":"Ng","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences, University of Leicester, Glenfield Hospital, Groby Road, Leicester LE3 9QP, UK"},{"name":"Department of Cardiology, The View Hospital, Ad-Dauha, Qatar"},{"name":"Department of Cardiology, University Hospitals of Leicester NHS Trust, Glenfield Hospital, Leicester LE3 9QP, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mustafa","family":"Zakkar","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences, University of Leicester, Glenfield Hospital, Groby Road, Leicester LE3 9QP, UK"},{"name":"Department of Cardiac Surgery, University Hospitals of Leicester NHS Trust, Glenfield Hospital, Leicester LE3 9QP, UK"},{"name":"Faculty of Medicine, University of Damascus, Damascus, Syria"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,2,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1016\/S0140-6736(14)61774-8","article-title":"50 year trends in atrial fibrillation prevalence, incidence, risk factors, and mortality in the Framingham Heart Study: A cohort study","volume":"386","author":"Schnabel","year":"2015","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1523","DOI":"10.1093\/cvr\/cvaa241","article-title":"Global variations in the prevalence, treatment, and impact of atrial fibrillation in a multi-national cohort of 153\u2009152 middle-aged individuals","volume":"117","author":"Joseph","year":"2020","journal-title":"Cardiovasc. 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