scholarly journals Gender Issues in Italian Catheterization Laboratories: The Gender‐CATH Study

2021 ◽  
Vol 10 (5) ◽  
Author(s):  
Chiara Bernelli ◽  
Enrico Cerrato ◽  
Rebecca Ortega ◽  
Emanuela Piccaluga ◽  
Elisabetta Ricottini ◽  
...  
Keyword(s):  
Gender Equity ◽  
Interventional Cardiology ◽  
Coronary Intervention ◽  
Catheterization Laboratory ◽  
Safety Issues ◽  
Percutaneous Coronary ◽  
Gender Based ◽  
Changing Demographics ◽  
The Impact ◽  
Gender Specific

Background Women represent an increasing percentage of interventional cardiologists in Italy compared with other countries. However, gaps exist in understanding and adapting to the impact of these changing demographics. Methods and Results We performed a national survey to analyze demographics, gender‐based professional difference, needs in terms of catheterization laboratory (Cath‐Lab) abstention, and radiation safety issues in Italian Cath‐Lab settings. A survey supported by the Italian Society of Interventional Cardiology (Società Italiana di Cardiologia Interventistica–Gruppo Italiano di Studi Emodinamici SICI‐GISE) was mailed to all SICI‐GISE members. Categorical data were compared using the χ 2 test. P <0.05 was considered significant. There were 326 respondents: 20.2% were <35 years old, and 64.4% had >10 years of Cath‐Lab experience. Notably, 26.4% were women. Workload was not gender‐influenced (women performed “on‐call” duty 69.8% versus men 68.3%; P =0.97). Women were more frequently unmarried (22.1% women versus 8.7% men; P =0.002) and childless (43.9% versus 56.1%; P <0.001). Interestingly, 69.8% of women versus 44.6% of men ( P <0.001) argued that pregnancy/breastfeeding negatively impacts professional skill development and career advancement. For Cath‐Lab abstention, 38.9% and 69.6% of respondents considered it useful to perform percutaneous coronary intervention robotic simulations and "refresh‐skill" sessions while they were absent or on return to work, respectively, without gender differences. Overall, 80% of respondents described current radioprotection counseling efforts as inadequate and not gender specific. Finally, 26.7% faced some type of job discrimination, a significantly higher proportion of whom were women. Conclusions Several gender‐based differences exist or are perceived to exist among interventional cardiologists in Italian Cath‐Labs. Joint strategies addressing Cath‐Lab abstention and radiation exposure education should be developed to promote gender equity in interventional cardiologists.

The impact of gender on outcomes in patients with chronic total coronary occlusions undergoing percutaneous coronary intervention: results from a Dutch nationwide registry including 7560 patients

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A Van Veelen ◽  
J Elias ◽  
I.M Van Dongen ◽  
J.P.S Henriques ◽  
P Knaapen
Keyword(s):  
Cardiovascular Disease ◽  
Percutaneous Coronary Intervention ◽  
Survival Curve ◽  
Coronary Intervention ◽  
Chronic Total Occlusions ◽  
Nationwide Registry ◽  
Percutaneous Coronary ◽  
Baseline Characteristics ◽  
Gender Based ◽  
The Impact

Abstract Background Females comprise a minority of patients with chronic total occlusions (CTO). It is known that men have a greater benefit from CTO percutaneous coronary intervention (PCI) than women. We aimed to determine gender-based differences in baseline characteristics and outcomes after PCI in patients with CTO. Methods The Netherlands Heart Registration (NHR) is a nationwide registry that registers outcomes of cardiac interventions. For the purpose of this analysis, the data of all patients undergoing PCI from inception of the NHR to December 2018 were selected, that included PCI with at least one CTO in one of the treated coronary arteries. We compared baseline characteristics and the outcomes 1 year mortality, 30 day myocardial infarction (MI) and target vessel revascularization (TVR) &lt;1 year between men and women. Results A total of 7560 patients were identified that underwent PCI between January 1, 2015 and December 31, 2018 with at least 1 CTO in the treated vessel. A total of 5850 was male (77.4%) and 1710 was female (22.6%). Women were older (68.5±10.6 versus 64.7±10.6 years old, p&lt;0.001), and more frequently had diabetes (29.4% [n=529] versus 25.0% [n=1602], p&lt;0.001) and kidney disease (4.5% [n=529] versus 2.2% [n=142], p&lt;0.001). However, men had more extensive cardiovascular disease, i.e. multi-vessel disease (56.0% [n=3584] versus 50.4% [n=912], p&lt;0.001), previous MI (39.7% [n=2527] versus 31.0% [n=555], p&lt;0.001), previous PCI (48.2% [n=1967] versus 40.2% [n=455], p&lt;0.001) and previous coronary artery bypass grafting (16.8% [n=1085] versus 10.5% [n=191], p&lt;0.001) and more frequently presented with an out-of-hospital cardiac arrest, compared to women (2.1% [n=136] versus 1.1% [n=20], p=0.004). The 1-year mortality was higher in women (10.3% versus 7.5%, p&lt;0.001), as well as the 30-day MI (0.9% versus 0.4%, p=0.043), but men had higher risk for TVR&lt;1 year (11.7% versus 9.5%, p=0.044). Corrected for age and comorbidities, female gender was an independent predictor for mortality (Figure 1; odds ratio 1.83, 95% confidence interval 1.08–3.11, p=0.025). Conclusion In this nationwide registry comprising 7560 CTO patients undergoing PCI, significant gender-based differences were found. Males were found to have more extensive cardiovascular disease. However, females were at higher risk of mortality, possibly due to higher age and higher prevalence of concomitant comorbidities. Figure 1. Survival curve Funding Acknowledgement Type of funding source: None

scholarly journals StaBle Angina: PeRceptIon of NeeDs, Quality of Life and ManaGemEnt of Patients (BRIDGE Study)—A Multinational European Physician Survey

Angiology ◽  
2018 ◽  
Vol 70 (5) ◽  
pp. 397-406 ◽  
Author(s):  
Giuseppe Ambrosio ◽  
Peter Collins ◽  
Ralf Dechend ◽  
Jose Lopez-Sendon ◽  
Athanasios J. Manolis ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Stable Angina ◽  
Coronary Intervention ◽  
Interventional Treatment ◽  
Web Based ◽  
Percutaneous Coronary ◽  
Duration Of Disease ◽  
Gender Based ◽  
The Impact

Stable angina (SA) is a chronic condition reducing physical activity and quality of life (QoL). Physicians treating patients with SA in Italy, Germany, Spain, and United Kingdom completed a web-based survey. The objective was to assess physician perceptions of patient needs, the impact of SA on QoL, and evaluate SA management. Overall, 659 physicians (cardiologists and general practitioners) entered data from 1965 eligible patients. The perceived importance of everyday activities for patients with a recent diagnosis (≤2 years) was higher than for patients with a longer diagnosis (>2 years), while severity of limitations for those activities were rated similarly for both groups. Gender-based analyses revealed that physicians documented more severe SA, more symptoms and more angina attacks in women, yet they rated the patients’ condition as similar for both sexes. Women also received less medical and interventional treatment. Patients who have previously had a percutaneous coronary intervention (PCI) had more severe SA, despite more intense medical treatment, than patients with no previous PCI. In conclusion, severity, symptoms, and impact of SA on health status and everyday life activities vary by duration of disease, gender, and previous PCI. However, physicians do not seem to attach appropriate importance to these differences.

Percutaneous Coronary Intervention in Patients with Diabetes and Multivessel or Left Main Disease – a Review

2012 ◽  
Vol 7 (1) ◽  
pp. 37
Author(s):  
Donald E Cutlip ◽  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Statistical Significance ◽  
Bare Metal Stents ◽  
Coronary Intervention ◽  
Metal Stents ◽  
Increased Risk ◽  
Percutaneous Coronary ◽  
Patients With Diabetes ◽  
The Impact

Coronary artery disease in patients with diabetes is frequently a diffuse process with multivessel involvement and is associated with increased risk for myocardial infarction and death. The role of percutaneous coronary intervention (PCI) versus coronary artery bypass grafting (CABG) in patients with diabetes and multivessel disease who require revascularisation has been debated and remains uncertain. The debate has been continued mainly because of the question to what degree an increased risk for in-stent restenosis among patients with diabetes contributes to other late adverse outcomes. This article reviews outcomes from early trials of balloon angioplasty versus CABG through later trials of bare-metal stents versus CABG and more recent data with drug-eluting stents as the comparator. Although not all studies have been powered to show statistical significance, the results have been generally consistent with a mortality benefit for CABG versus PCI, despite differential risks for restenosis with the various PCI approaches. The review also considers the impact of mammary artery grafting of the left anterior descending artery and individual case selection on these results, and proposes an algorithm for selection of patients in whom PCI remains a reasonable strategy.

Aspirin I.V. Loading during Elective Percutaneous Coronary Intervention

Pharmacology ◽  
2021 ◽  
pp. 1-5
Author(s):  
David Naguib ◽  
Carolin Helten ◽  
Saif Zako ◽  
Philipp Mourikis ◽  
René M’Pembele ◽  
...  
Keyword(s):  
Pilot Study ◽  
Light Transmission ◽  
Platelet Reactivity ◽  
Coronary Intervention ◽  
Bleeding Complications ◽  
Loading Dose ◽  
Bleeding Events ◽  
Elective Percutaneous Coronary Intervention ◽  
Percutaneous Coronary ◽  
The Impact

Additional loading dose of acetylsalicylic acid (ASA) during percutaneous coronary interventions (PCIs) despite permanent oral ASA medication is frequently applicated. The impact on platelet reactivity and clinical events is not known. In this pilot study, we aimed to analyze high on-treatment platelet reactivity (HTPR) to aspirin in patients undergoing elective PCI. Platelet reactivity was measured using light-transmission aggregometry in 100 patients on permanent low-dose ASA medication undergoing elective PCI. Platelet reactivity measured by arachidonic acid-induced maximum of aggregation (MoA) in patients with versus without additional peri-procedural ASA loading (500 mg i.v.) was compared. HTPR was defined as MoA &#x3e;20% for ASA. Major adverse cerebro- and cardiovascular events (MACCEs) and bleeding events were evaluated during hospital course. HTPR rate was similar in both groups (HTPR to ASA: loading vs. control 6% vs. 16%, odds ratio [OR] = 0.33, 95% confidence interval [CI] 0.08–1.35, <i>p</i> = 0.12). In-hospital MACCEs were not different between groups (MACCE: loading vs. control: 0 vs. 0 patient, OR = 1.32, 95% CI 0.03–67.95, <i>p</i> = 0.89). Thrombolysis in myocardial infarction minimal bleedings were numerically higher in patients without ASA loading dose. In this pharmacodynamic pilot study, additional ASA loading did not reduce HTPR to ASA. Furthermore, ASA loading did not increase in-hospital MACCE and bleeding complications.

Sign in / Sign up

Export Citation Format

Share Document