Sex differences in patients undergoing heart transplantation and LVAD therapy

Advanced Heart Failure Characteristics and Outcomes in Women and Men

“…Our observational data on the use of advanced HF therapies, including LVAD and heart transplant, align with national and international data demonstrating lower use of advanced therapies in women. 11 , 13 , 50 , 51 , 52 , 53 , 54 Although the reasons for this are likely multifactorial, our data do add insights into epidemiologic differences that may underlie the lower referral and ultimate use of advanced therapies among women and men. LVAD has been demonstrated to be beneficial in patients with severely reduced EF.…”

“…This selected subgroup primarily comprises younger patients with severely reduced EF, and is a population dominated by men (up to 70%–75%). 11 Multifactorial reasons for lower use of advanced therapies in women than men have been proposed including greater propensity to opt out, poorer surgical candidacy, and possible inequity with respect to allocation. 11 , 12 , 13 Epidemiological differences in advanced HF likely partially underly these disparities but have not been well explored.…”

“… 11 Multifactorial reasons for lower use of advanced therapies in women than men have been proposed including greater propensity to opt out, poorer surgical candidacy, and possible inequity with respect to allocation. 11 , 12 , 13 Epidemiological differences in advanced HF likely partially underly these disparities but have not been well explored. Additionally, whether women and men affected with advanced HF have different outcomes requires further evaluation.…”

Saving women's hearts: Improving outcomes with prevention & policy

“…Women with atrial fibrillation are less likely to be adequately anticoagulated [22] , less likely to receive non-vitamin K oral anticoagulants [22] , and less likely to receive rhythm control treatment including ablation procedures when compared with men [ 23 , 24 ]. There are also differences in management of men and women with advanced heart failure, with lower use of GDMT in women compared with men [25] . Additionally, women only received one-quarter of all left ventricular assist devices and hearts transplanted in the United States [26] .…”

CWHHA ATLAS: EPIDEMIOLOGY, DIAGNOSIS AND MANAGEMENT OF CARDIOVASCULAR DISEASES IN WOMEN Chapter 9: Summary of Current Status, Challenges, Opportunities, and Recommendations

“… 27 , 28 , 29 , 30 Survival rates are lower in women after LVAD implantation further stratified according to race/ethnicity, 31 but not after heart transplantation. 32 However, women are more prone to post-LVAD (eg, ischemic and hemorrhagic stroke, pump thrombosis, device malfunction, and right ventricular failure) and post heart transplantation (eg, allograft failure and antibody-mediated rejection, but not malignancy or cardiac allograft vasculopathy) complications. 29 , 32 , 33 , 34 The persistent issue of under-representing female patients in clinical trials might be attributable to factors including the lack of female investigators leading knowledge generation and dissemination, ineligibility of individuals of childbearing age, and lower referral rates of women to cardiology clinics, because women are approximately 3 times less likely to receive CRT or ICD therapy.…”