0
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Italian Association of Hospital Cardiologists Position Paper ‘Gender discrepancy: time to implement gender-based clinical management’

      research-article
      , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,
      European Heart Journal Supplements : Journal of the European Society of Cardiology
      Oxford University Press
      Cardiovascular drugs, Cardiovascular therapy, Gender, Gender differences, Pharmacodynamics, Pharmacokinetics, Sex, Women

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          It has been well assessed that women have been widely under-represented in cardiovascular clinical trials. Moreover, a significant discrepancy in pharmacological and interventional strategies has been reported. Therefore, poor outcomes and more significant mortality have been shown in many diseases. Pharmacokinetic and pharmacodynamic differences in drug metabolism have also been described so that effectiveness could be different according to sex. However, awareness about the gender gap remains too scarce. Consequently, gender-specific guidelines are lacking, and the need for a sex-specific approach has become more evident in the last few years. This paper aims to evaluate different therapeutic approaches to managing the most common women’s diseases.

          Related collections

          Most cited references326

          • Record: found
          • Abstract: not found
          • Article: not found

          2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure

            Bookmark
            • Record: found
            • Abstract: found
            • Article: found
            Is Open Access

            Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017

            Summary Background Global development goals increasingly rely on country-specific estimates for benchmarking a nation's progress. To meet this need, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 estimated global, regional, national, and, for selected locations, subnational cause-specific mortality beginning in the year 1980. Here we report an update to that study, making use of newly available data and improved methods. GBD 2017 provides a comprehensive assessment of cause-specific mortality for 282 causes in 195 countries and territories from 1980 to 2017. Methods The causes of death database is composed of vital registration (VR), verbal autopsy (VA), registry, survey, police, and surveillance data. GBD 2017 added ten VA studies, 127 country-years of VR data, 502 cancer-registry country-years, and an additional surveillance country-year. Expansions of the GBD cause of death hierarchy resulted in 18 additional causes estimated for GBD 2017. Newly available data led to subnational estimates for five additional countries—Ethiopia, Iran, New Zealand, Norway, and Russia. Deaths assigned International Classification of Diseases (ICD) codes for non-specific, implausible, or intermediate causes of death were reassigned to underlying causes by redistribution algorithms that were incorporated into uncertainty estimation. We used statistical modelling tools developed for GBD, including the Cause of Death Ensemble model (CODEm), to generate cause fractions and cause-specific death rates for each location, year, age, and sex. Instead of using UN estimates as in previous versions, GBD 2017 independently estimated population size and fertility rate for all locations. Years of life lost (YLLs) were then calculated as the sum of each death multiplied by the standard life expectancy at each age. All rates reported here are age-standardised. Findings At the broadest grouping of causes of death (Level 1), non-communicable diseases (NCDs) comprised the greatest fraction of deaths, contributing to 73·4% (95% uncertainty interval [UI] 72·5–74·1) of total deaths in 2017, while communicable, maternal, neonatal, and nutritional (CMNN) causes accounted for 18·6% (17·9–19·6), and injuries 8·0% (7·7–8·2). Total numbers of deaths from NCD causes increased from 2007 to 2017 by 22·7% (21·5–23·9), representing an additional 7·61 million (7·20–8·01) deaths estimated in 2017 versus 2007. The death rate from NCDs decreased globally by 7·9% (7·0–8·8). The number of deaths for CMNN causes decreased by 22·2% (20·0–24·0) and the death rate by 31·8% (30·1–33·3). Total deaths from injuries increased by 2·3% (0·5–4·0) between 2007 and 2017, and the death rate from injuries decreased by 13·7% (12·2–15·1) to 57·9 deaths (55·9–59·2) per 100 000 in 2017. Deaths from substance use disorders also increased, rising from 284 000 deaths (268 000–289 000) globally in 2007 to 352 000 (334 000–363 000) in 2017. Between 2007 and 2017, total deaths from conflict and terrorism increased by 118·0% (88·8–148·6). A greater reduction in total deaths and death rates was observed for some CMNN causes among children younger than 5 years than for older adults, such as a 36·4% (32·2–40·6) reduction in deaths from lower respiratory infections for children younger than 5 years compared with a 33·6% (31·2–36·1) increase in adults older than 70 years. Globally, the number of deaths was greater for men than for women at most ages in 2017, except at ages older than 85 years. Trends in global YLLs reflect an epidemiological transition, with decreases in total YLLs from enteric infections, respiratory infections and tuberculosis, and maternal and neonatal disorders between 1990 and 2017; these were generally greater in magnitude at the lowest levels of the Socio-demographic Index (SDI). At the same time, there were large increases in YLLs from neoplasms and cardiovascular diseases. YLL rates decreased across the five leading Level 2 causes in all SDI quintiles. The leading causes of YLLs in 1990—neonatal disorders, lower respiratory infections, and diarrhoeal diseases—were ranked second, fourth, and fifth, in 2017. Meanwhile, estimated YLLs increased for ischaemic heart disease (ranked first in 2017) and stroke (ranked third), even though YLL rates decreased. Population growth contributed to increased total deaths across the 20 leading Level 2 causes of mortality between 2007 and 2017. Decreases in the cause-specific mortality rate reduced the effect of population growth for all but three causes: substance use disorders, neurological disorders, and skin and subcutaneous diseases. Interpretation Improvements in global health have been unevenly distributed among populations. Deaths due to injuries, substance use disorders, armed conflict and terrorism, neoplasms, and cardiovascular disease are expanding threats to global health. For causes of death such as lower respiratory and enteric infections, more rapid progress occurred for children than for the oldest adults, and there is continuing disparity in mortality rates by sex across age groups. Reductions in the death rate of some common diseases are themselves slowing or have ceased, primarily for NCDs, and the death rate for selected causes has increased in the past decade. Funding Bill & Melinda Gates Foundation.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Dapagliflozin in Patients with Heart Failure and Reduced Ejection Fraction

              In patients with type 2 diabetes, inhibitors of sodium-glucose cotransporter 2 (SGLT2) reduce the risk of a first hospitalization for heart failure, possibly through glucose-independent mechanisms. More data are needed regarding the effects of SGLT2 inhibitors in patients with established heart failure and a reduced ejection fraction, regardless of the presence or absence of type 2 diabetes.
                Bookmark

                Author and article information

                Contributors
                Journal
                Eur Heart J Suppl
                Eur Heart J Suppl
                ehjsupp
                European Heart Journal Supplements : Journal of the European Society of Cardiology
                Oxford University Press (UK )
                1520-765X
                1554-2815
                April 2024
                16 May 2024
                16 May 2024
                : 26
                : Suppl 2 , Abstracts from the 55th Congress of the Italian Association of Hospital Cardiologists (ANMCO) Rimini, 16–18 May 2024 and ANMCO Papers
                : ii264-ii293
                Affiliations
                Cardiology Department, Grande Ospedale Metropolitano GOM, Reggio Calabria, Via Melacriono , 1, 89129 Reggio, Calabria, Italy
                Cardio-Cerebro-Rehabilitation Department, Azienda Sanitaria Friuli Occidentale , (AS FO) Via della Vecchia Ceramica, 1, Pordenone 33170, Italy
                Cardiology Unit, Cardiology Spoke Cetraro-Paola, San Franceco di paola Hospital , 87027 Paola, CS, Italy
                Cardiology Unit, Cardiology Spoke Cetraro-Paola, San Franceco di paola Hospital , 87027 Paola, CS, Italy
                Cardiology Unit, Cardiology “Paolo Borsellino” Hospital, Contrada Cardilla , 91025 Marsala, TP, Italy
                Cardiology Department, Grande Ospedale Metropolitano GOM, Reggio Calabria, Via Melacriono , 1, 89129 Reggio, Calabria, Italy
                Cardio-Thoraco-Vascular Department, San Camillo Forlanini Hospital , 00152 Roma, Italy
                Cardiology Clinics, ‘F.’ Hospital Jaia’ , 70014 Conversano, BA, Italy
                San Paolo Hospital , 70132 Bari, Italy
                Ospedale del Mare di Napoli - ASL Napoli , 80147 Napoli, Italy
                U.O.C. Cardiologia, Nuovo Ospedale Versilia , Lido di Camaiore, Italy
                Cardiology Unit, Sant’Andrea Hospital , 19100 La Spezia, SP, Italy
                Cardiology Division, Giovanni Paolo II Hospial , 88046 Lamezia Terme, CZ, Italy
                Interventional Cardiology, IRCCS Ospedale San Raffaele , 20132 Milano, Italy
                Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Policlinico Umberto I Hospital, Sapienza University of Rome , 00161 Roma, Italy
                Levante Cardiology, San Paolo Hospital , Savona, 17100 Savona, SV, Italy
                Cardiolog Unit, Ospedale dell’Angelo , 30172 Mestre, Italy
                Cardiology Unit, San Filippo Neri Hospital , 00135 Roma, Italy
                Cardiology Unit, Cariovascular Department , ‘A. De Gasperis’, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milano, Italy
                Cardiac Surgery Unit, Santa Maria della Misericordia Hospital , 33100 Udine, UD, Italy
                Department of Experimental and Clinical Medicine , Florence University, 50121 Firenze, Italy
                Pediatric and Transition Cardiology Unit, Meyer University Hospital , 50139 Florence, Italy
                Cardiology Unit, Cardiology Spoke Cetraro-Paola, San Franceco di paola Hospital , 87027 Paola, CS, Italy
                Pediatric and Transition Cardiology Unit, Meyer University Hospital , 50139 Florence, Italy
                Cardiology Unit, Sant'Antonio Abate di Erice , 91016 Erice, Trapani, Italy
                Cardiology Unit, Cannizzaro Hospital , Catania 95126, Italy
                Cardiologia, ASP Trapani , 91100 Trapani, TP, Italy
                Cardiology Unity 1, Cardiology 1, Cardiovascular Department , Papa Giovanni XXIII Hospital, 24127 Bergamo, Italy
                Cardiology Unity, San Giuseppe Moscati Hospital , 83100 Avellino, Italy
                Cardiac Surgery Unit, San Camillo Forlanini Hospital , 00152 Roma, Italy
                Dipartimento di Cardiologia, Ospedale Santo Spirito , Casale Monferrato, Italy
                Cardiology Unity, San Camillo Forlanini Hospital , 00152 Roma, Italy
                Cardiology Unity, San Donato Hospital , 52100 Arezzo, Italy
                Cardiology Unity, Umberto I Di Torino Hospital , 10128 Torino, Italy
                Federico Nardi, Cardiology Unit, Casale Monferrato Hospital , 15033 Casale Monferrato (AL), Italy
                Cardiology Unity 1, Cardiology 1, Cardiovascular Department , Papa Giovanni XXIII Hospital, 24127 Bergamo, Italy
                Cardiology Department, Grande Ospedale Metropolitano GOM, Reggio Calabria, Via Melacriono , 1, 89129 Reggio, Calabria, Italy
                Post-Acute Patient Follow-up Unit, Cardio-Vascular Department , AORN Sant'Anna and San Sebastiano, Caserta, Italy
                Cardiology Department , 12100 Cuneo, CN, Italy
                Ospedale Della Murgia “Fabio Perinei” , 70022 Altamura BA, Italy
                Clinical-Surgical Cardiology, A.O.U. Siena, Santa Maria alle Scotte Hospital , 53100 Siena, Italy
                Department of Geriatrics, Center for Aging Medicine , Catholic University of the Sacred Heart and IRCCS Fondazione Policlinico A. Gemelli, 00168 Rome, Italy
                Dipartimento Cardio-Toraco-Vascolare, U.O.C. Cardiologia, Azienda Ospedaliera San Camillo Forlanini , Roma, Italy
                Fondazione per il Tuo cuore—Heart Care Foundation , 50121 Firenze, Italy
                Cardiology Division, Coronary Intensive Care Unit , Miulli Hospital, 70021 Acquaviva delle Fonti, Italy
                Cardiology Unit, San Filippo Neri Hospital , 00135 Roma, Italy
                Cardiology Unit, Cariovascular Department , ‘A. De Gasperis’, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milano, Italy
                Author notes
                Corresponding authors. Tel: 349/4122107, Email: fabiana.luca92@ 123456gmail.com (FL)
                Corresponding authors. Tel: 335/6030069, Email: daniela.pavan@ 123456asfo.sanita.fvg.it , dapavan10@ 123456gmail.com (DP)

                Conflict of interest: None declared.

                Author information
                https://orcid.org/0000-0002-5369-5382
                https://orcid.org/0000-0003-1513-7125
                https://orcid.org/0000-0002-2002-5024
                https://orcid.org/0000-0001-5954-3796
                https://orcid.org/0000-0002-8586-9930
                https://orcid.org/0000-0003-0092-8717
                https://orcid.org/0000-0001-8417-7783
                https://orcid.org/0000-0002-7298-2037
                https://orcid.org/0000-0003-0471-0053
                https://orcid.org/0000-0002-9347-8884
                Article
                suae034
                10.1093/eurheartjsupp/suae034
                11110461
                38784671
                435ec4bf-4ccc-4c5b-bb60-3efd4ab75126
                © The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License ( https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.

                History
                Page count
                Pages: 30
                Funding
                Funded by: Centro Servizi ANMCO SrL—Società Benefit;
                Categories
                ANMCO 2024 Supplement
                AcademicSubjects/MED00200

                cardiovascular drugs,cardiovascular therapy,gender,gender differences,pharmacodynamics,pharmacokinetics,sex,women

                Comments

                Comment on this article