Underrepresentation of Women in Reduced Ejection Heart Failure Clinical Trials With Improved Mortality or Hospitalization

Ekpo, Eson; Balla, Sujana; Ngo, Summer; Witting, Celeste; Sarraju, Ashish; Furst, Adam; Rodriguez, Fatima

doi:10.1016/j.jacadv.2023.100743

Cited by 5 publications

(3 citation statements)

References 57 publications

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“…Another limitation is that many participants are not heavily involved in HF care in terms of patient volume, and thus in specialty care the picture could be different. We did not inquire on possible perceived gender differences in the management of HF patients, and this should be further investigated whether physicians apply GDMT differently depending on their own and patients and physician gender ( 53 , 54 ). Finally, this only refers to clinical practice in Sweden up to 2021–2022 and might not be generalizable to other settings.…”

Section: Discussionmentioning

confidence: 99%

The management of heart failure in Sweden—the physician’s perspective: a survey

Ferrannini,

Biber,

Abdi

et al. 2024

Front. Cardiovasc. Med.

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AimsTo assess the barriers to guideline-directed medical therapy (GDMT) use in heart failure (HF), diagnostic workup and general knowledge about HF among physicians in Sweden.MethodsA survey about the management of HF was sent to 828 Swedish physicians including general practitioners (GPs) and specialists during 2021–2022. Answers were reported as percentages and comparisons were made by specialty (GPs vs. specialists).ResultsOne hundred sixty-eight physicians participated in the survey (40% females, median age 43 years; 41% GPs and 59% specialists). Electrocardiography and New York Heart Association class evaluations are mostly performed once a year by GPs (46%) and at every outpatient visit by specialists (40%). Echocardiography is mostly requested if there is clinical deterioration (60%). One-third of participants screen for iron deficiency only if there is anemia. Major obstacles to implementation of different drug classes in HF with reduced ejection fraction are related to side effects, with no significant differences between specialties. Device implantation is deemed appropriate regardless of aetiology (69%) and patient age (86%). Specialists answered correctly to knowledge questions more often than GPs. Eighty-six percent of participants think that GDMT should be implemented as much as possible. Most participants (57%) believe that regular patient assessment in nurse-led HF clinics improve adherence to GDMT.ConclusionObstacles to GDMT implementation according to physicians in Sweden mainly relate to potential side effects, lack of specialist knowledge and organizational aspects. Further efforts should be placed in educational activities and structuring of nurse-led clinics.

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Section: Discussionmentioning

confidence: 99%

The management of heart failure in Sweden—the physician’s perspective: a survey

Ferrannini,

Biber,

Abdi

et al. 2024

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

show abstract

“…In conclusion, the study by Ekpo et al 4 serves as a wake-up call to the medical research community about the ongoing sex disparity in HF clinical trials. While the problem is clear, the solutions require concerted efforts from all stakeholders, including researchers, industry sponsors, and regulatory bodies.…”

mentioning

confidence: 92%

“…In this issue of JACC: Advances , Ekpo et al 4 present a thought-provoking study that adds to the growing body of evidence indicating that women are underrepresented in HF clinical trials. In their analysis, they specifically included HF clinical trials that observed mortality or hospitalization for HF, and they mirrored the timeline used by the 2022 American Heart Association/American College of Cardiology/Heart Failure Society of America Guidelines for the Management of Heart Failure, 5 which included studies that were published through September 2021.…”

mentioning

confidence: 99%