Gender-specific clinical trials needed to address CVD in women

NATIONAL REPORTS-Cardiovascular disease (CVD) is underrecognized and undertreated in women, despite its prevalence, which is almost equal to that in men, according to a new survey.

The report from Women In Innovations (WIN), a group of interventional cardiologists within the Society for Cardiovascular Angiography and Interventions, surveyed more than 300 women living with and at-risk for heart disease, plus their friends and family members.

A full 30% of respondents said they waited more than 30 days to seek medical treatment after they had experienced symptoms of CVD or heart attack. Twenty-two percent waited one to five days, and 34% waited less than a day.

The WIN survey found a lack of recognition of CVD by providers, which results in women not receiving early medical interventions, including percutaneous coronary intervention (PCI) or angiography. Only 33% of PCIs done annually are done on women.

"We have known for a while that there are disparities in care and diagnosis and treatment of CVD between women and men," says Anne Beal, MD, president of the Aetna Foundation. "This study was a bit problematic in that it didn't ask why there are these disparities."

The answer, according to Dr. Beal, is improved quality of care overall for men and women.

And while current evidence-based guidelines recommend that men and women receive the same treatment, the WIN report suggest that women with unstable angina are less likely to be prescribed aspirin or statin therapy during hospitalization or after discharge.

Women presenting with heart attack symptoms are less likely than men to receive an electrocardiogram (ECG) within 10 minutes of presentation. They are also less likely to be cared for by a cardiologist during their inpatient admission, or be given heparin or ACE inhibitors acutely.

"This study established that we need more women in clinical trials," Dr. Beal says. "But before we start thinking about getting more women into clinical trials, we need to do the right thing now in the diagnosis and treatment of CVD in women in acute situations with just the very basics of care, like ECGs. Again, if we focus on improving the quality of care we administer, we can potentially reduce disparities of care."

Results show that 80% of women who had CVD had never considered participating in clinical trials.

Only 10% of survey respondents noted that their physicians had spoken to them about participating in a clinical trial when they received their initial diagnosis of CVD or myocardial infarction.