Disparities by Sex, Race, and Ethnicity in Use of Left Ventricular Assist Devices and Heart Transplants Among Patients With Heart Failure With Reduced Ejection Fraction

Rose, Scott W.; Strackman, Braden W.; Gilbert, Olivia N.; Lasser, Karen E.; Paasche‐Orlow, Michael K.; Lin, Meng‐Yun; Saylor, Georgia; Hanchate, Amresh D.

doi:10.1161/jaha.123.031021

Cited by 5 publications

(1 citation statement)

References 41 publications

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“…For example, women with heart failure receive fewer left ventricular assist devices (LVADs) [90][91][92]. The disparity of access to cardiovascular MDs is confirmed by very recent studies, which have evidenced that the use of LVADs in patients with heart failure with a reduced ejection fraction was smaller in women [93], such as the use of catheter ablation for rhythm control in atrial fibrillation [94]. Interestingly, it has also been evidenced that the effect of sex and gender on access to catheter ablation and LVADs intersect with racial and ethnic aspects.…”

Section: Access To Mdsmentioning

confidence: 99%

The Appropriateness of Medical Devices Is Strongly Influenced by Sex and Gender

Campesi,

Franconi,

Serra

2024

Life

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Until now, research has been performed mainly in men, with a low recruitment of women; consequentially, biological, physiological, and physio-pathological mechanisms are less understood in women. Obviously, without data obtained on women, it is impossible to apply the results of research appropriately to women. This issue also applies to medical devices (MDs), and numerous problems linked to scarce pre-market research and clinical trials on MDs were evidenced after their introduction to the market. Globally, some MDs are less efficient in women than in men and sometimes MDs are less safe for women than men, although recently there has been a small but significant decrease in the sex and gender gap. As an example, cardiac resynchronization defibrillators seem to produce more beneficial effects in women than in men. It is also important to remember that MDs can impact the health of healthcare providers and this could occur in a sex- and gender-dependent manner. Recently, MDs’ complexity is rising, and to ensure their appropriate use they must have a sex–gender-sensitive approach. Unfortunately, the majority of physicians, healthcare providers, and developers of MDs still believe that the human population is only constituted by men. Therefore, to overcome the gender gap, a real collaboration between the inventors of MDs, health researchers, and health providers should be established to test MDs in female and male tissues, animals, and women.

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Section: Access To Mdsmentioning

confidence: 99%

The Appropriateness of Medical Devices Is Strongly Influenced by Sex and Gender

Campesi,

Franconi,

Serra

2024

Life

View full text Add to dashboard Cite

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Racial and Ethnic Disparities in Peri-and Post-operative Cardiac Surgery

Scott,

Gouchoe,

Azap

et al. 2024

Curr Cardiovasc Risk Rep

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Purpose of Review Despite efforts to curtail its impact on medical care, race remains a powerful risk factor for morbidity and mortality following cardiac surgery. While patients from racial and ethnic minority groups are underrepresented in cardiac surgery, they experience a disproportionally elevated number of adverse outcomes following various cardiac surgical procedures. This review provides a summary of existing literature highlighting disparities in coronary artery bypass surgery, valvular surgery, cardiac transplantation, and mechanical circulatory support. Recent Findings Unfortunately, specific causes of these disparities can be difficult to identify, even in large, multicenter studies, due to the complex relationship between race and post-operative outcomes. Current data suggest that these racial/ethnic disparities can be attributed to a combination of patient, socioeconomic, and hospital setting characteristics. Summary Proposed solutions to combat the mechanisms underlying the observed disparate outcomes require deployment of a multidisciplinary team of cardiologists, anesthesiologists, cardiac surgeons, and experts in health care equity and medical ethics. Successful identification of at-risk populations and the implementation of preventive measures are necessary first steps towards dismantling racial/ethnic differences in cardiac surgery outcomes.

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