Contributions of Women to Cardiovascular Science Over Two Decades: Authorship, Leadership, and Mentorship.

Background Women remain underrepresented in cardiology. We aimed to assess gender trends in research authorship, authorship in leading roles, mentorship, and research team diversity. Methods and Results We identified "cardiac and cardiovascular systems" journals from 2002 to 2020 using Journal Citation Reports 2019 (Web of Science, Clarivate Analytics). Gender authorship, mentorship, research team diversity, and trends were assessed. Associations between author gender and impact factor, journal region, and cardiology subspecialties were analyzed. Analysis of 396 549 research papers from 122 journals showed the percentage of women authors increased from 16.6% to 24.6% (=0.38 [95% CI, 0.29-0.46]; <0.001), whereas the proportion of women first (=-0.03 [95% CI, -0.06 to 0.004]; =0.09) or last authors (=-0.017 [95% CI, -0.04 to 0.006]; =0.15) was unchanged. Compared with men last authors, women last authors were more likely to mentor women first authors and lead more diverse research teams (both <0.001). Journal impact factor was related to percentage of women authors overall (Spearman's correlation coefficient R=0.208 [95% CI, 0.02-0.38]; =0.03) but not first or last women authors (both 0.5). Women comprised 18.4%-25.7% of authors in cardiology subspecialties. Journal region and author gender were unrelated (all 0.4). Conclusions Women's inclusion as authors of cardiology papers increased slightly over the past 2 decades, yet the proportions of women in first and last authorship roles were unchanged. Women are increasingly likely to mentor women first authors and lead diverse research teams. Women last authors are essential to increasing diversity of future independent investigators and inclusive research teams, both of which are associated with innovation and excellence in science.