The Society for Cardiovascular Angiography & Interventions (SCAI) has announced the release of an expert consensus statement on sex-specific considerations in myocardial revascularisation, which it said aims to summarise available literature on myocardial revascularisation in women and identify important gaps in evidence. The document was published in JSCAI, the Society’s recently-launched official journal.
In a press release, SCAI said that utilisation of cardiovascular procedures is far lower in women than men, and women continue to be underrepresented in cardiovascular clinical trials, severely limiting the opportunity to better understand sex differences in cardiovascular drug or device outcomes. Current practice guidelines do not address sex-based differences and fail to highlight when insufficient evidence exists regarding cardiovascular outcomes in women, resulting in overall poorer outcomes.
“This consensus is an international collaborative effort that highlights the knowns, the gaps and ambiguities in evidence related to sex-specific revascularisation,” says Alexandra Lansky, professor of medicine in the section of Cardiology at the Yale School of Medicine and a practicing cardiologist at Yale-New Haven Hospital, New Haven, USA. “As a companion to the recent percutaneous coronary intervention (PCI) guidelines, it will inform clinicians on best practices most relevant to our female patients and draws attention to areas in need of additional evidence.”
The paper explores gaps in evidence in several areas including the epidemiology of ischaemic heart disease, diagnostic tools to guide coronary revascularisation, revascularisation for chronic coronary syndromes, revascularisation for non-ST-elevation myocardial infarction (MI) and ST-elevation MI, and revascularisation consideration for specific patient populations, vascular access in women, and more.
“Physicians can use this consensus document to inform their discussions with female patients on the risks and benefits of coronary revascularisation,” said J Dawn Abbott, co-chair of the document and professor of Medicine and director of the Interventional Cardiology Fellowship Training Program at Brown Medical School, Providence, USA. “An understanding of the limitations of the data is important in this regard,” Abbott concluded.
Authors of the paper state that while the evidence supporting clinical decisions in women is lacking, these findings are important to guide prospective investigation and establish research priorities.