Key result
Women represent just ~2% of TAVR proceduralists and remain profoundly under-enrolled in landmark clinical trials.
Why the study?
Women are under-represented among TAVR and TMVr operators, motivating an assessment of the representation of women as patients, proceduralists, and trial authors in major structural interventions.
Women are significantly under-represented as proceduralists, trial authors, and patients in structural interventional cardiology, which may negatively impact trial recruitment, guideline recommendations, and sex-specific data analysis.
Answers are grounded in this paper and cite their sources.
Under-representation of women as structural proceduralists and authors may limit sex-specific evidence; leaves open effects of diversity initiatives on trial enrollment.
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.
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Burgess et al. (2022) conducted a review in Severe aortic stenosis and severe mitral regurgitation. Transcatheter aortic valve replacement (TAVR) and transcatheter mitral valve repair (TMVr) was evaluated. Women are profoundly under-represented in structural interventional cardiology, comprising only 2% of TAVR and 1% of TMVr proceduralists, and are under-enrolled in landmark clinical trials.
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