Burgess Sonya, Cader F Aaysha, Shaw Elizabeth, Banerjee Shrilla, Stehli Julia, Krishnamorthy Roopa, Khor Lynn, Forotan Homa, Bastiany Alexandra, Rao Sarita, Chandrasekhar Jaya, Zaman Sarah, Alasnag Mirvat, Chieffo Alaide, Coylewright Megan
Department of Medicine, University of Sydney Sydney, New South Wales, Australia.
Department of Cardiology, Nepean Hospital Sydney, New South Wales, Australia.
Eur Cardiol. 2022 Dec 19;17:e27. doi: 10.15420/ecr.2022.33. eCollection 2022 Feb.
Women are under-represented among transcatheter aortic valve replacement (TAVR) and transcatheter mitral valve repair (TMVr) operators. This review assesses the representation of women as patients and as proceduralists and trial authors in major structural interventions. Women are under-represented as proceduralists in structural interventions: only 2% of TAVR operators and 1% of TMVr operators are women. Only 1.5% of authors in landmark clinical TAVR and TMVr trials are interventional cardiologists who are women (4/260). Significant under-representation and under-enrolment of women in landmark TAVR trials is evident: the calculated participation-to-prevalence ratio (PPR) is 0.73, and in TMVr trials, the PPR is 0.69. Under-representation of women is also evident in registry data (PPR = 0.84 for TAVR registries and for TMVr registries). In structural interventional cardiology, women are under-represented as proceduralists, trial participants and patients. This under-representation has the potential to affect the recruitment of women to randomised trials, subsequent guideline recommendations, selection for treatment, patient outcomes and sex-specific data analysis.
在经导管主动脉瓣置换术（TAVR）和经导管二尖瓣修复术（TMVr）的操作人员中，女性所占比例较低。本综述评估了女性在主要结构性干预措施中作为患者、手术医生和试验作者的占比情况。在结构性干预措施中，女性作为手术医生的占比很低：TAVR手术医生中只有2%是女性，TMVr手术医生中只有1%是女性。在具有里程碑意义的TAVR和TMVr临床研究中，只有1.5%的作者是女性介入心脏病专家（4/260）。在具有里程碑意义的TAVR试验中，女性的代表性明显不足且入组率低：计算得出的参与率与患病率之比（PPR）为0.73，在TMVr试验中PPR为0.69。登记数据中也明显存在女性代表性不足的情况（TAVR登记处和TMVr登记处的PPR = 0.84）。在结构性介入心脏病学领域，女性作为手术医生、试验参与者和患者的占比均较低。这种代表性不足有可能影响女性参与随机试验的招募、后续的指南建议、治疗选择、患者预后以及性别特异性数据分析。
