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

Despite substantial advances in interventional cardiology, profound disparities in access to care and clinical outcomes remain across racial/ethnic and sex groups. These inequities arise from a complex interplay of biological differences, structural barriers, and sociocultural determinants that shape disease recognition, treatment allocation, procedural decision-making, and long-term follow-up. A further driver is the limited understanding of cardiovascular disease in female patients and racial/ethnical minorities, largely attributable to their persistent underrepresentation in clinical research, thereby restricting the external validity of evidence and perpetuating gaps in practice. This review explores how social and biological dimensions intersect to influence risk profiles, clinical presentation, procedural strategies, and secondary prevention in contemporary practice, focusing on the 2 most widely performed interventions in cardiology: percutaneous coronary intervention and transcatheter aortic valve replacement. It also highlights how such differences are often not integrated into standardized pathways of care, allowing inequities to persist even in the era of advanced cardiovascular technologies. Ultimately, it may serve as a call to action: advancing equity in interventional cardiology requires more than representative trial enrollment. It demands reform in study design, systematic stratification of outcomes, and structural change in care delivery to ensure that innovations in cardiovascular medicine benefit all patients.