Primary outcomes
During the monitoring period of 50.36 ± 19.65 months, 1718 patients
remained free of AF, accounting for 74.9% of the study cohort. This
included 77.1% of male participants and 71.2% of female participants.
Among these recurrences, persistent AF was noted in 70 patients,
constituting 12.2% of the cases, with no significant difference
observed across groups.
The Kaplan-Meier curves reveal a statistically significant difference in
AF-free survival between male and female patients
(HR [95%CI]
1.305[1.101-1.547], p=0.0014) (Figure 2).
This gender disparity persists in
the PSM population with a similar trend and an increased HR
(1.363[1.117-1.663], p=0.0020) (Supplementary Figure S1). Early
catheter ablation has been proposed6,20. we compared
AF recurrence between genders in two groups: those with a
diagnosis-to-ablation time ≤ 1 year and > 1 year. As
illustrated in Supplementary Figure S2, the gender-based difference in
AF recurrence remained consistent regardless of whether the intervention
occurred early or late (HR 1.327, 95%CI 1.017-1.732 for ≤ 1 year, and
HR 1.284, 95%CI 1.029-1.601 for > 1 year).
The incidence of MACCE was 1.64 per 100 patient-year for female and 1.36
per 100 patient-year for male with no statistical differences among
groups (HR 1.227, 95%CI 0.877-1.716, p=0.232). The majority of MACCE
were new thromboembolic events with 0.93 and 0.69 per 100 patient-year
for female and male respectively (HR 1.382, 95%CI 0.876-2.180,
p=0.165).