TCT-365 Pregnancy-Induced Disorders Identify High-Risk Women who Benefit from Cardiovascular Screening: Results from the Women's Heart Health Initiative, an OB/GYN Screening Pilot Program

Abstract

Results:Patients with liver disease were younger and represented more minorities in comparison to patients without liver disease undergoing PCI. They had significantly higher rates of renal and pulmonary disease and were more likely to be on insulin therapy, but had a similar prevalence of prior coronary artery disease history, myocardial infarction, heart failure and cardiac risk factors. Rates of multivessel disease, intervention success and anti-platelet therapy were not significantly different between groups. There was no increased incidence of peri-procedural complications including bleeding requiring transfusion (pϭ0.29), major entry site complications (pϭ0.70), and stroke (pϭ0.70). At 1 year, cumulative event rates, including death, myocardial infarction, coronary artery bypass graft surgery, and repeat PCI were similar between the groups (Table 1).Background: Cardiovascular (CV) disease is the leading cause of mortality among women in the US. Despite targeted public health initiatives, many women remain unaware of and undertreated for their CV risk factors. Methods: We surveyed women presenting to obstetrics and gynecology (OB/GYN) clinics for the presence of traditional and non-traditional CV risk factors and any current symptoms using a simple, one-page questionnaire. Blood pressure and cholesterol were measured if there was no prior screening. Results: 2,863 patients were surveyed at 16 US centers from May 2010 to June 2012. The mean age was 51 Ϯ 14 years. 45% were post-menopausal. The majority of pts had no prior diagnosis of myocardial infarction, angina or stroke (96%). However, 82% of women had at least one CV risk factor (figure) and 41% had a CV complaint such as chest pain, dyspnea, or palpitations. A significant proportion of women did not know if they had diabetes, hyperlipidemia or hypertension (18%, 36% and 18% respectively). 74% of women had a primary care physician (PCP). As a result of screening, 25% of patients were referred to another health care provider, in most of cases to a PCP (45%) or a cardiologist (28%). Conclusions: Screening women presenting to community OB/GYN clinics with a one-page questionnaire in this pilot, multicenter program, revealed a high prevalence of CV risk factors and symptoms, and may enhance the early detection and treatment of CV disease in female patients. Whether screening patients in this setting will translate into improved long-term outcomes warrants further evaluation.