Percutaneous coronary and structural interventions in women: a position statement from the EAPCI Women Committee

EuroIntervention 2018;14:e1227-e1235 published online May 2018 published online e-edition December 2018. DOI: 10.4244/EIJ-D-18-00225

Alaide Chieffo
Alaide Chieffo1*, MD; Gill Louise Buchanan2, MBChB, FRCP; Julinda Mehilli3,4,5, MD; Davide Capodanno6, MD; Vijay Kunadian7, MD; Anna Sonia Petronio8, MD; Ghada W. Mikhail9, MD, FRCP; Piera Capranzano6, MD; Nieves Gonzalo10, MD, PhD; Nicole Karam11, MD, PhD; Stéphane Manzo-Silberman12, MD; Stefanie Schüpke5,13, MD; Robert A. Byrne5,13, MD; Giuliana Capretti1, MD; Yolande Appelman14, MD; Marie-Claude Morice15, MD; Patrizia Presbitero16, MD; Maria Radu17, MD; Josepa Mauri18, MD, PhD; on behalf of EAPCI Women Committee
1. San Raffaele Scientific Institute, Milan, Italy; 2. North Cumbria University Hospitals, Carlisle, United Kingdom; 3. Department of Cardiology, Zentralklinik Bad Berka, Bad Berka, Germany; 4. Ludwig-Maximilians-University of Munich, Munich, Germany; 5. German Center for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, Germany; 6. University of Catania, Catania, Italy; 7. Institute of Cellular Medicine, Newcastle University and Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne, United Kingdom; 8. AOUP Cisanello, University Hospital, Pisa, Italy; 9. Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, United Kingdom; 10. Hospital Clinico San Carlos, Madrid, Spain; 11. Georges Pompidou European Hospital, Paris, France; 12. Hôpital Lariboisière, Université Paris VII, Paris, France; 13. Deutsches Herzzentrum München, Technische Universität München, Munich, Germany; 14. VU University Medical Center, Amsterdam, the Netherlands; 15. Institut Hospitalier Jacques Cartier, Ramsay Générale de Santé, Massy, France; 16. Humanitas Hospital, Milan, Italy; 17. The Heart Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; 18. Hospital Universitari Germans Trias i Pujol, Badalona, Spain

Several expert documents on sex-based differences in interventional outcomes are now available; however, this is the first position paper from the EAPCI Women Committee discussing the potential influence of sex in the percutaneous treatment of coronary and structural heart disease. Despite the misconception that coronary artery disease is a “man’s disease”, contemporary data show a growing incidence in women. However, women are under-represented in randomised coronary clinical trials (~25%). The generalisation of such studies is, therefore, problematic in decision making for females undergoing coronary intervention. Differences in pathophysiology between sexes exist, highlighting the need for greater awareness amongst healthcare professionals to enable best evidence-based therapies for women as well as for men. Reassuringly, women represent half of the population included in transcatheter aortic valve implantation clinical trials and may actually benefit more. Growing evidence is also emerging for other interventional atrial procedures which may well be advantageous to women. Awareness of sex disparities is increasing, and we must all work collaboratively within our profession to ensure that we provide effective care for all patients with heart disease. The EAPCI Women Committee aims to highlight such issues through this position paper and through visibility within the interventional community.

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