Heart failure

Assessing the Causes of Gender Disparity in Heart Failure Trials

This article was originally published here

Heart. Mar 31, 2022: heartjnl-2021-320696. doi: 10.1136/heartjnl-2021-320696. Online ahead of print.


OBJECTIVES: Cardiovascular diseases are one of the leading causes of mortality and morbidity in women. Despite this, even in contemporary research, female patients are poorly represented in trials. This study aimed to explore the reasons for gender disparity in heart failure (HF) trials.

METHODS: HF trials published in seven high-impact clinical journals (impact factor >20), between 2000 and 2020, were identified. Trials with more than 300 participants of both sexes were included. Large HF records, as well as population statistics, were also identified using the same criteria.

RESULTS: We identified 146 heart failure trials, which included a total of 248,620 patients. The median proportion of patients was 25.8%, with the lowest proportions seen in trials of patients with ischemic cardiomyopathy (17.9%), severe systolic dysfunction (left ventricular ejection fraction (LVEF )

CONCLUSIONS: A significant gender disparity was identified in the HF trials, most noticeable in trials evaluating patients with severely reduced LVEF and ischemic etiology. This is likely due to a complex interplay between registration bias and biological variation. Moreover, the degree of these two aspects can vary according to the type of test. In the future, we should encourage all HF trials to evaluate their recruitment log and suggest the reasons for any reported gender disparities.

PMID:35361671 | DO I:10.1136/heartjnl-2021-320696