Report from a large and comprehensive single-center Women’s Health Cardiology Clinic

Q: What are the key findings of this study?

Multidisciplinary Women's Health Cardiology Clinic evaluation of 985 women identified endothelial dysfunction in 40% of the 388 tested patients and established atherosclerosis in 14%.

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Cardiovascular disease risk with traditional and women-specific risk factors (n=985). Intervention: Multidisciplinary Women's Health Cardiology Clinic evaluation (including endothelial function testing and psychological intervention). Primary outcome: Endothelial dysfunction (Reactive Hyperemia Index <1.67 on EndoPAT testing).

Q: What does this research mean for the field?

Specialized multidisciplinary evaluation in a Women's Health Cardiology Clinic reveals a substantial burden of cardiovascular risk, with endothelial dysfunction detected in 40% of tested patients and established atherosclerosis in 14%. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Shlomit Schuchalter Ludmir; Tamir Bental; Osnat Itzhaki Ben Zadok; Alon Eisen; Tzippy Shochat; Irit Heruti; Ran Kornowski; Avital Porter

doi:10.1177/17455065211013767

January 1, 2021Women s HealthOpen Access

Report from a large and comprehensive single-center Women’s Health Cardiology Clinic

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Key result

Specialized women's cardiology clinic evaluation identifies endothelial dysfunction in ~40% of tested patients.

n=985

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Why the study?

To describe the patient population and work at a specialized multidisciplinary Women's Health Cardiology Clinic to raise awareness of women-specific cardiovascular disease risk factors and improve clinical outcomes.

Key Points

To describe the patient population and clinical profile at a specialized Women's Health Cardiology Clinic to increase awareness of female-specific cardiovascular risk factors.
Retrospective descriptive analysis of electronic medical records from 985 women (accumulating 2062 visits) seen between January 2014 and December 2018 at a single-center Women's Health Cardiology Clinic.
A multidisciplinary team delivered sex-specific cardiovascular assessments, psychological interventions, and specialized diagnostics, including endothelial function testing.
The median age was 57.5 years; 58% (575 women) were menopausal, 6% (62 women) had pregnancy complications, and 3% (25 women) had active or prior breast cancer.
Cardiovascular disease risk factors were common, with at least 30% having diabetes, hypertension, or dyslipidemia; 72 women had prior cerebrovascular events or acute coronary syndrome, and 139 had evidence of atherosclerosis.
Among 388 women who underwent endothelial function testing, 40% exhibited endothelial dysfunction (reactive hyperemia index <1.67), including 82% of tested pregnant women with complications.

Study Design

Type

Cohort (n=985)

Multicenter

No

Structured PICO

P

Population

985 women (median age 57.5 years, 100% female) referred to a single-center multidisciplinary Women's Health Cardiology Clinic in Israel between January 2014 and December 2018.

E

Exposure

Multidisciplinary gender-specific cardiovascular care evaluation and management (collaborating cardiologist, nurse, medical psychologist, nutritionist, and social worker), including non-invasive endothelial function testing using peripheral arterial tonometry (EndoPAT), 1-3 nutritional consultations, and 1-12 psychological interventions.

O

Outcome

Descriptive prevalence of cardiovascular risk factors, established atherosclerosis (by coronary angiography, CT, or carotid Doppler), and endothelial dysfunction (defined as reactive hyperemia index [RHI] <1.67 on EndoPAT testing).surrogate

This single-center registry demonstrates that a multidisciplinary Women's Health Cardiology Clinic can successfully integrate assessment of sex-specific risk factors, endothelial function testing, and psychological support to identify high rates of subclinical vascular dysfunction in women.

Limitations

Single-center experience, which may not be relevant to all.
Some of the women subpopulations are quite small and more women are needed for future research.
Data was collected retrospectively from medical files, and not all files had complete data regarding each patient (specifically endothelial function tests were not performed in all women).
Cardiovascular disease clinical outcomes were not explored in the included women.
Single-center experience, which may not be generalizable to all settings
Small sample sizes in some subpopulations (e.g., breast cancer and pregnancy complications)
Retrospective data collection from electronic medical files with incomplete data (e.g., endothelial function testing not performed in all women)
Cardiovascular disease clinical outcomes were not examined

Ask about this paper

Answers are grounded in this paper and cite their sources.

Implication

May support specialized clinics for detecting subclinical vascular disease in women; leaves open whether testing improves outcomes.

Abstract

OBJECTIVE: This article describes the women population and work at a unique Women's Health Cardiology Clinic in order to raise cardiovascular disease awareness with an emphasis on women-specific risk factors, and thus to improve women's clinical outcomes. This expectantly will aid in opening similar centers allowing more women to get superior care. METHODS: Electronic medical records of women referred to the Women's Health Cardiology Clinic were analyzed. The statistical analysis is descriptive in nature. Women's Health Cardiology Clinic personnel work as a multidisciplinary team, and patients receive specialized diagnostic tests and treatments. Referrals are by physicians according to traditional and women's specific risk factors for cardiovascular disease. RESULTS: 985 women visited the Women's Health Cardiology Clinic, accumulating 2062 visits. Median age was 57.5 years. The majority of the women were menopausal (575 women, 58%), 62 pregnant with complications and 25 oncology patients. At least, 30% of women had diabetes/hypertension/or dyslipidemia. 72 women had a history of either cerebrovascular event or acute coronary syndrome, and 139 women had evidence of atherosclerosis. Overall, 388 women underwent endothelial function test, 40% of these women had a score indicating endothelial dysfunction. 277 women underwent a psychological intervention. CONCLUSION: Described here are the experiences from a multidisciplinary Women's Health Cardiology Clinic using a gender-specific cardiovascular care approach for women geared toward improved health and wellbeing. It is of utmost importance that this report will raise women-specific cardiovascular disease risk factors awareness in order to promote women's cardiovascular and overall health.

Discussion

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Cite This Study

Ludmir et al. (2021) conducted a cohort in Cardiovascular disease risk with traditional and women-specific risk factors (n=985). Multidisciplinary Women's Health Cardiology Clinic evaluation (including endothelial function testing and psychological intervention) was evaluated on Endothelial dysfunction (Reactive Hyperemia Index <1.67 on EndoPAT testing). Multidisciplinary Women's Health Cardiology Clinic evaluation of 985 women identified endothelial dysfunction in 40% of the 388 tested patients and established atherosclerosis in 14%.

synapsesocial.com/papers/6a7c42a4f056b38aaddf955f https://doi.org/10.1177/17455065211013767

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Report from a large and comprehensive single-center Women’s Health Cardiology Clinic

Figures

Key Points

Study Design

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Report from a large and comprehensive single-center Women’s Health Cardiology Clinic

Figures

Key Points

Study Design

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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