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SCAI Expert Consensus Statement on Sex-Specific Considerations in Myocardial Revascularization

Consensus Statement Health Equity Women's Health

This consensus statement summarizes the available literature on myocardial revascularization in women and identifies gaps in evidence that could prompt prospective investigation.

Background

Cardiovascular disease (CVD) is the leading cause of death for women world-wide, claiming an estimated 8.5 million lives globally and 400,000 in the United States alone on an annual basis.

Despite significant declines in overall CVD mortality, access and timely delivery of optimal treatment for women lags significantly behind men, resulting in poorer outcomes.

Utilization of cardiovascular procedures, such as cardiac catheterization, percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG), mechanical circulatory support (MCS), and implantable defibrillators, is far lower in women compared with men, independent of disease prevalence or severity.

Furthermore, women continue to be underrepresented in cardiovascular clinical trials, thereby blunting the chance of understanding sex differences in cardiovascular drug or device outcomes. Accordingly, current society practice guidelines do not address sex-based differences and fail to highlight when insufficient evidence exists regarding cardiovascular outcomes in women.

The purpose of this consensus is to summarize the available literature on myocardial revascularization in women and to identify gaps in evidence that can prompt prospective investigation.

All authors: Alexandra Lansky, MD, FSCAI (Chair), Suzanne J. Baron, MD, MSc, Cindy L. Grines, MD, MSCAI, Jennifer A. Tremmel, MD, MS, FSCAI, Rasha Al-Lamee, MBBS, MA, PhD, FSCAI, Dominick J. Angiolillo, MD, PhD, FSCAI, Alaide Chieffo, MD, FSCAI, Kevin Croce, MD, FSCAI, Alice K. Jacobs, MD, MSCAI, Mina Madan, MD, MHS, FSCAI, Akiko Maehara, MD, FSCAI, Julinda Mehilli, MD, FSCAI, Roxana Mehran, MD, MSCAI, Vivian Ng, MD, FSCAI, Puja B. Parikh, MD, MPH, FSCAI, Jacqueline Saw, MD, FSCAI, and J. Dawn Abbott, MD, FSCAI (Co-Chair). 

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