Reducing Cardiovascular Disease, Disparities in Women

Kevin Kunzmann

Investigators discuss recently-published secondary sex-based assessments into PCI treatment, as well as their contribution to cardiovascular research action points that lessen the field's disparities.

New secondary findings from the TWILIGHT trial, presented at the American College of Cardiology (ACC) 2021 Scientific Sessions this weekend by Birgit Vogel, MD, of the Icahn School of Medicine, highlighted sex-based disparities and similarities in bleeding risk, ischemic events and aspirin adherence or cutoff benefit in patients with percutaneous coronary intervention (PCI) receiving ticagrelor and aspirin.

The timely discussion around the sex-based assessment of the 7119-participant trial turned to the matters of women cardiovascular intervention research, a matter which Vogel and fellow study author and colleague Roxana Mehran, MD, explained is continually burdened by low representation of women in trials including TWILIGHT.

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“When you think you’re seeing a biologic difference, you correct for the baseline risk, and you’re still seeing hazard but can’t say anything about it, then it’s probably because we’re still underpowered—we just don’t have enough women,” Mehran explained. “If we had as many women as men, we might have been able to show a difference.”

In the second segment of an interview with HCPLive, the study authors discussed their work in the TWILIGHT assessment, as well as their work newly-published agendas that address the key needs for women cardiovascular intervention research improvement.

As Vogel explained, the impact of sex on cardiovascular outcomes is multifaceted.

“We need to see what are the sex-specific differences we have to consider in different areas—in prevention, but also in treatment,” Vogel said. “And it really starts with the enrollment of more women in clinical trials, and that’s what we have to make our priority.”