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17-06-2024 | Atrial Fibrillation | Original Research

Gender and Age Differences in the Evaluation and Clinical Outcomes of Patients with Palpitations

Authors: Sun Young Jeong, MD, MPH, Aiyu Chen, MPH, Yi-lin Wu, MS, Ming-Sum Lee, MD, PhD

Published in: Journal of General Internal Medicine

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Abstract

Background

Palpitations represent a common clinic complaint.

Objective

To explore gender and age differences in the evaluation and outcomes of patients with palpitations in outpatient settings.

Design/participants

This is a retrospective observational study of 58,543 patients with no known structural cardiac disease or arrythmias presenting to primary care and cardiology clinics in an integrated health system in California with palpitations between January 2017 and December 2021. The primary and secondary endpoints were hospitalization for arrhythmia and all-cause mortality at 1 year. Multivariable logistic regression models evaluated the association between gender, age, and outcomes.

Results

Men and women were equally as likely to be started on beta-blockers (adjusted OR 0.96, 95% CI 0.90–1.02) and evaluated with electrocardiograms (adjusted OR 0.95, 95% CI 0.90–1.01) and cardiac monitors (adjusted OR 1.04, 95% CI 0.99–1.08). Patients who completed Holter or event monitors had a lower rate of hospitalization for cardiovascular disease at 1 year than those without (2.3% vs. 2.7%, p = 0.001). At 1 year, women had a lower risk of all-cause mortality (adjusted OR 0.47, 95% CI 0.35–0.64) and hospitalization for atrial fibrillation (adjusted OR 0.47, 95% CI 0.30–0.72) and arrhythmias (adjusted OR 0.73, 95% CI 0.58–0.91) compared to men. Among older women and men (≥ 80 years), there was no significant difference in 1-year all-cause mortality (adjusted OR 0.57, 95% CI 0.29–1.12), hospitalization for atrial fibrillation (adjusted OR 0.58, 95% CI 0.17–1.97), or arrhythmias (adjusted OR 1.15, 95% CI 0.12–11.07).

Conclusions

There were no gender differences in referrals for cardiac monitoring or prescriptions for beta-blockers. Women had a better prognosis with a lower risk of hospitalization for arrhythmias and death at 1 year compared to men. However, 1-year risks for mortality and hospitalization for arrythmias among older women were comparable to those of older men, underscoring the importance of considering age and gender in managing patients with palpitations.
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Metadata
Title
Gender and Age Differences in the Evaluation and Clinical Outcomes of Patients with Palpitations
Authors
Sun Young Jeong, MD, MPH
Aiyu Chen, MPH
Yi-lin Wu, MS
Ming-Sum Lee, MD, PhD
Publication date
17-06-2024
Publisher
Springer International Publishing
Published in
Journal of General Internal Medicine
Print ISSN: 0884-8734
Electronic ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-024-08860-1
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