Hormone Replacement Therapy and Adverse Outcomes in Women With Atrial Fibrillation
An Analysis From the Atrial Fibrillation Follow-Up Investigation of Rhythm Management Trial
Background and Purpose—Hormone replacement therapy (HRT) use has been related to thromboembolism, but whether HRT increases adverse outcomes in females with atrial fibrillation is uncertain.
Methods—We used the Atrial Fibrillation Follow-Up Investigation of Rhythm Management (AFFIRM) trial data set that included 1594 women (39.3% of the population, mean age 71±8), of whom 376 (23.6%) were taking HRT at baseline. The primary end point, a composite of all-cause death, stroke, systemic/pulmonary embolism, and myocardial infarction, and secondary outcomes (ie, each individual end point) and major bleeding, were considered.
Results—HRT was not independently associated with the primary end point (hazard ratio=0.894; 95% confidence interval, 0.658–1.214; P=0.473) or any secondary outcome. Age (P<0.001), diabetes mellitus (P<0.001), previous stroke (P=0.011), and heart failure (P<0.001) predicted the primary end point. Lack of association between HRT and the primary end point was confirmed in a propensity score–matched control group (hazard ratio=0.966; 95% confidence interval, 0.663–1.409; P=0.858).
Conclusions—HRT does not independently predict mortality, thromboembolism, or bleeding in a large cohort of women with atrial fibrillation.
- Received July 7, 2014.
- Revision received July 7, 2014.
- Accepted July 15, 2014.
- © 2014 American Heart Association, Inc.