Abstract:
:Physicians previously perceived heart disease to be a man's disease; yet, since 1984, more women have died of ischemic heart disease. Because women who develop obstructive coronary heart disease and heart failure tend to do so 10 years later than men, cardiology clinical trials that use arbitrary age cutoffs or exclusion criteria based on comorbidities and polypharmacy often limit the pool of potential participants to a greater extent for women. Issues related to trial design and insufficient accounting for female-predominant disease patterns have contributed to low rates of enrollment of women in certain domains of cardiology research. Accordingly, women do not benefit from as rich an evidence base for cardiology as men. Here, we review major sex differences in heart disease and discuss areas of cardiology research in which women have been underrepresented. Considering the widespread sex differences in cardiovascular structure and function, it is important to include balanced numbers of women and men in cardiovascular clinical trials. Beyond inclusion, sex-specific reporting is also essential. Moreover, with ongoing developments of clinical-trial methodology, it is imperative to seek innovative ways to learn as much as possible about how interventions behave in women and men. Adaptive trials are specifically identified as promising opportunities to consider sex-based analyses at interim stages, allowing sex-specific flexibility as these trials unfold. Finally, we emphasize the importance of factoring sex as a biological variable into the design, analysis, and reporting of preclinical research, because this research critically informs the design and execution of clinical trials.
journal_name
Clin Cardioljournal_title
Clinical cardiologyauthors
Clayton JA,Arnegard MEdoi
10.1002/clc.22907subject
Has Abstractpub_date
2018-02-01 00:00:00pages
179-184issue
2eissn
0160-9289issn
1932-8737journal_volume
41pub_type
杂志文章,评审abstract:BACKGROUND:Myocardial infarction in the absence of obstructive coronary artery disease (MINOCA) accounts for approximately 5% - 6% of acute myocardial infarction (AMI) patients. Anxiety symptoms are common in patients with coronary artery disease (CAD), and are associated with a poor prognosis. However, the association...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.23386
更新日期:2020-07-01 00:00:00
abstract::Despite the proven benefits of using antiplatelet therapy in patients undergoing percutaneous coronary intervention (PCI), a number of key questions remain to be answered. In recent years, clopidogrel dosing strategies among such patients have evolved considerably, with newer approaches involving loading doses prior t...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.20359
更新日期:2008-03-01 00:00:00
abstract:BACKGROUND:The role of electrocardiogram (ECG) is unclear for the longitudinal follow-up of patients who undergo corrective surgery for isolated severe tricuspid regurgitation (TR). HYPOTHESIS:This study sought to investigate the usefulness of changes in QRS duration of ECG after TR surgery in predicting right ventric...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.22030
更新日期:2012-11-01 00:00:00
abstract::Catheter ablation has become an accepted technique for creating complete heart block in patients with drug refractory supraventricular tachycardias. However, it remains experimental for other indications, such as ablation of accessory pathway or ventricular tachycardia. The use of high energy defibrillator discharges ...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.4960140712
更新日期:1991-07-01 00:00:00
abstract:BACKGROUND:Anticoagulation with heparin is recommended with intra-aortic balloon pump (IABP) to prevent thrombosis and embolization. However, anticoagulation increases the risk of bleeding, particularly in combination with glycoprotein (GP) IIb/IIIa antagonists. HYPOTHESIS:We investigated the safety of using GP IIb/II...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.20297
更新日期:2009-02-01 00:00:00
abstract::In order to assess the diagnostic value of dipyridamole (D) testing, we studied the responses of 34 patients with chest pain and 10 normal subjects. Blood pressure and 12-lead ECG were recorded during and after intravenous infusion of 0.6 mg/kg dipyridamole for 10 minutes. Coronary arteriography and maximal or symptom...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960050402
更新日期:1982-04-01 00:00:00
abstract:BACKGROUND:Early reperfusion therapy has reduced the infarct size and mortality rate in patients with acute myocardial infarction (AMI). The occurrence of bundle-branch block in AMI is related to the amount of myocardial damage and the insult to the conduction system. HYPOTHESIS:To evaluate the clinical and angiograph...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960241204
更新日期:2001-12-01 00:00:00
abstract:BACKGROUND:Cibenzoline, a class Ia antiarrhythmic drug, can be used to relieve left ventricular (LV) outflow obstruction in hypertrophic obstructive cardiomyopathy (HOCM). However, the mechanism of this agent in HOCM has been controversial. HYPOTHESIS:This study was designed to investigate the effect of cibenzoline on...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960230911
更新日期:2000-09-01 00:00:00
abstract::Patients with atrial fibrillation (AF) have an increased stroke risk compared with those in sinus rhythm, although the absolute risk for individual patients is modulated by the presence of various additional risk factors. Patient selection for oral anticoagulation for stroke prevention is based on risks of stroke and ...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.22122
更新日期:2013-06-01 00:00:00
abstract:BACKGROUND:Troponin I (TnI) is increasingly employed as a highly specific marker of acute myocardial ischemia. The value of this marker after cardiac surgery is unclear. HYPOTHESIS:The purpose of this study was to measure serum TnI levels prospectively at 1, 6, and 72 h after elective cardiac operations. In addition, ...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960231009
更新日期:2000-10-01 00:00:00
abstract::Heart transplantation is the only curative therapy for chronic heart failure, and it plays an important role in the treatment of chronic heart failure with a survival rate of approximately 50% of all patients after 10 years. This has to be kept in mind when alternative therapies enter into our daily routine in treatin...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.22124
更新日期:2013-07-01 00:00:00
abstract:BACKGROUND:Brugada syndrome (BrS) is associated with sudden cardiac death (SCD). Although implantable cardioverter-defibrillator (ICD) implantation is recommended, the long-term outcomes and follow-up data with regard to ICD complications have led to controversy. HYPOTHESIS:In the present study, we described the data ...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.23247
更新日期:2019-10-01 00:00:00
abstract:BACKGROUND:Intravenous inotropic intervention in congestive heart failure is generally associated with a poor prognosis and is largely used as a "bridge" to mechanical support or heart transplantation. HYPOTHESIS:We hypothesized that the inotropic support afforded by dobutamine may serve as a bridge to the introductio...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960240311
更新日期:2001-03-01 00:00:00
abstract::Congestive heart failure (CHF) is a common manifestation of hypertension, coronary artery disease, and dilated cardiomyopathy. The Framingham study showed that the incidence of CHF increases twofold with each decade of age. The presence of CHF increases the age-adjusted death rate 5.5-fold for women and 8-fold for men...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:
更新日期:1992-09-01 00:00:00
abstract::Recent clinical investigations have provided new insights into physiologic alterations taking place as heart failure progresses. As a result, new end points may be more relevant to monitor in patients, rather than the classical assessment of severity based on subjective evaluation of functional capacity. Structural ch...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.4960181603
更新日期:1995-09-01 00:00:00
abstract:BACKGROUND:Insulin resistance is clearly associated with coronary artery disease (CAD) in diabetics. Insulin resistance may also be present in normoglycemic individuals, and some of these patients can be diagnosed as having metabolic syndrome (MS) according to various definitions. However, the relationship between hype...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.20379
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:Exercise-based rehabilitation is an important part of treatment patients following coronary artery bypass graft (CABG) surgery. HYPOTHESIS:To evaluate effect of very short/short-term exercise training on cardiopulmonary exercise testing (CPET) parameters. METHODS:We studied 54 consecutive patients with myo...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.22656
更新日期:2017-05-01 00:00:00
abstract::Five multicenter, randomized, double-blind, placebo-controlled studies were conducted in France to compare the efficacy and safety of once-daily simvastatin treatment (10-40 mg/day) with conventional therapy with gemfibrozil 900 mg/day, ciprofibrate 100 mg/day, bezafibrate 400 mg/day, and fenofibrate 300 or 400 mg/day...
journal_title:Clinical cardiology
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1002/clc.4960181107
更新日期:1995-11-01 00:00:00
abstract:BACKGROUND:Heart failure (HF) readmission rates have become an increasingly important quality metric since the advent of the Hospital Readmissions Reduction Program. Despite many well-intentioned efforts to reduce readmissions, clinicians continue to struggle with the problem of high HF readmission rates. HYPOTHESIS:H...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.22738
更新日期:2017-10-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to examine the influence of atrial fibrillation (AF) on the immediate and long-term outcome of patients undergoing balloon mitral valvotomy (BMV). HYPOTHESIS:Patients with atrial fibrillation fair poorly after balloon mitral valvotomy. METHODS:There were a total of 818 consecu...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.22068
更新日期:2012-12-01 00:00:00
abstract::The short-term hemodynamic and possible arrhythmogenic effects of intravenous salbutamol at a dose of 30 or 60 micrograms/min were evaluated in 14 patients with severe chronic left ventricular dysfunction using equilibrium radionuclide angiocardiography and electrocardiographic monitoring. Salbutamol infusions at a do...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960130708
更新日期:1990-07-01 00:00:00
abstract::Tissue-type plasminogen activator (t-PA) derived from a melanoma cell line was first used in patients with acute myocardial infarction in the early 1980s. Recombinant DNA technology then allowed production of large amounts of t-PA. The TIMI-I trial used a two-chain recombinant (rt-PA) product. A predominantly single-c...
journal_title:Clinical cardiology
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1002/clc.4960160404
更新日期:1993-04-01 00:00:00
abstract::Several investigators have documented the successful use of oral sustained-release theophylline in treating symptomatic bradycardia and sick sinus syndrome. This paper reports a case of chronotropic incompetence in which specific exercise indices, including the chronotropic response index, were used to measure the the...
journal_title:Clinical cardiology
pub_type: 临床试验,杂志文章,评审
doi:10.1002/clc.4960231019
更新日期:2000-10-01 00:00:00
abstract::The coronary sinus (CS) is a small tubular structure just above the posterior left atrioventricular junction. The CS can be imaged in several different echocardiographic views. Using zoom M-mode recordings of the CS in apical two-chamber view, CS caliber can be sharply imaged and easily measured during different phase...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.4960230304
更新日期:2000-03-01 00:00:00
abstract::Recently two types of atypical T-wave evolution were recognized as electrocardiographic (ECG) markers of regional postinfarction pericarditis. The sensitivity and specificity of these changes for this condition were 100 and 77%, respectively. The major purpose of this investigation is to show how these ECG changes can...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960170903
更新日期:1994-09-01 00:00:00
abstract:BACKGROUND:Marfan's syndrome is an inherited disorder of connective tissue associated with characteristic abnormalities of the skeletal, ocular, and cardiovascular systems. Marked clinical variability and age dependency of all manifestations of Marfan's syndrome may render the unequivocal diagnosis difficult in mildly ...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960200311
更新日期:1997-03-01 00:00:00
abstract:BACKGROUND:Although women typically develop coronary artery disease several years after men, once they have symptomatic disease their thromboembolic complications are worse than in men. The mechanism mediating this gender difference in outcome after thromboembolic events is unknown. We previously studied platelet funct...
journal_title:Clinical cardiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1002/clc.4960191106
更新日期:1996-11-01 00:00:00
abstract::Thrombolytic therapy for prosthetic heart valve thrombosis has recently been receiving increased attention and is now frequently used an alternative to high-risk surgery. A case is presented describing a novel thrombolytic therapy regimen with emphasis on the role of transesophageal echocardiography in diagnosis and m...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.4960181117
更新日期:1995-11-01 00:00:00
abstract:BACKGROUND:Identifying patients with advanced left atrial (LA) remodeling before catheter ablation (CA) of atrial fibrillation (AF) is crucial. HYPOTHESIS:This study aimed to identify echocardiographic parameters associated with changes in anatomy and conduction properties of the left atrium (LA). METHODS:We examined...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.23515
更新日期:2021-01-01 00:00:00
abstract::Atrial septal aneurysm in the otherwise normal heart is a very rare and usually asymptomatic condition. A midsystolic click was described as the only clinical manifestation so far. A low-pitched early-to-midsystolic acoustic phenomenon in a 39-year-old woman corresponding with maximal leftward motion of the aneurysmat...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960150713
更新日期:1992-07-01 00:00:00