How Sex and Race/Ethnicity Influence Interventional Cardiology Outcomes: What Do We Know?

Area of Science:

• Cardiovascular Medicine
• Health Equity
• Interventional Cardiology

Background:

• Significant disparities persist in interventional cardiology access and outcomes across racial/ethnic and sex groups.
• These inequities stem from biological, structural, and sociocultural factors influencing patient care pathways.
• Underrepresentation of diverse populations in clinical research limits understanding and perpetuates practice gaps.

Purpose of the Study:

• To explore the intersection of social and biological factors in cardiovascular disease risk, presentation, and treatment.
• To examine how these disparities manifest in percutaneous coronary intervention and transcatheter aortic valve replacement.
• To highlight the need for integrating these differences into care to overcome persistent inequities.

Main Methods:

• This is a review article, synthesizing existing knowledge on disparities in interventional cardiology.
• Focuses on the influence of social and biological dimensions on risk, clinical presentation, procedural strategies, and secondary prevention.
• Examines the two most common interventions: percutaneous coronary intervention and transcatheter aortic valve replacement.

Main Results:

• Social and biological factors significantly intersect to affect cardiovascular disease risk and presentation.
• Disparities are evident in treatment allocation, procedural decision-making, and long-term follow-up.
• Current standardized care pathways often fail to address these differences, perpetuating inequities despite technological advances.

Conclusions:

• Advancing equity in interventional cardiology necessitates more than representative trial enrollment.
• Reforms in study design, outcome stratification, and care delivery are crucial.
• Structural changes are required to ensure cardiovascular medicine innovations benefit all patient populations equitably.