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Role of sex on the efficacy of pharmacological and non-pharmacological treatment of heart failure with reduced ejection fraction: A systematic review

BACKGROUND: Heart Failure (HF) is a growing epidemic with a similar prevalence in men and women. However, women have historically been underrepresented in clinical trials, leading to uneven evidence regarding the benefit of guideline-directed medical therapy (GDMT). This review aims to outline the s...

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Autores principales: Sanromán Guerrero, María Ascensión, Antoñana Ugalde, Sonia, Hernández Sánchez, Elena, del Prado Díaz, Susana, Jiménez-Blanco Bravo, Marta, Cordero Pereda, David, Zamorano Gómez, José Luis, Álvarez-García, Jesús
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9358690/
https://www.ncbi.nlm.nih.gov/pubmed/35958423
http://dx.doi.org/10.3389/fcvm.2022.921378
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author Sanromán Guerrero, María Ascensión
Antoñana Ugalde, Sonia
Hernández Sánchez, Elena
del Prado Díaz, Susana
Jiménez-Blanco Bravo, Marta
Cordero Pereda, David
Zamorano Gómez, José Luis
Álvarez-García, Jesús
author_facet Sanromán Guerrero, María Ascensión
Antoñana Ugalde, Sonia
Hernández Sánchez, Elena
del Prado Díaz, Susana
Jiménez-Blanco Bravo, Marta
Cordero Pereda, David
Zamorano Gómez, José Luis
Álvarez-García, Jesús
author_sort Sanromán Guerrero, María Ascensión
collection PubMed
description BACKGROUND: Heart Failure (HF) is a growing epidemic with a similar prevalence in men and women. However, women have historically been underrepresented in clinical trials, leading to uneven evidence regarding the benefit of guideline-directed medical therapy (GDMT). This review aims to outline the sex differences in the efficacy of pharmacological and non-pharmacological treatment of HF with reduced ejection fraction (HFrEF). METHODS AND RESULTS: We conducted a systematic review via Medline from inception to 31 January 2022, including all randomized clinical trials published in English including adult patients suffering HFrEF that reported data on the efficacy of each drug. Baseline clinical characteristics, primary outcomes, and sex-specific effects are summarized in tables. The systemic review has been conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. In total, 29 articles were included in the systematic review. We observed that the proportion of women enrolled in clinical trials was generally low, the absence of a prespecified analysis of efficacy by sex was frequent, and the level of quality of evidence on the efficacy of GDMT and implantable cardioverter defibrillator (ICD) or cardiac resynchronization therapy (CRT-) in women was relatively poor. CONCLUSIONS: Sex influences the response to treatment of patients suffering from HFrEF. All the results from the landmark randomized clinical trials are based on study populations composed mainly of men. Further studies specifically designed considering sex differences are warranted to elucidate if GDMT and new devices are equally effective in both sexes.
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spelling pubmed-93586902022-08-10 Role of sex on the efficacy of pharmacological and non-pharmacological treatment of heart failure with reduced ejection fraction: A systematic review Sanromán Guerrero, María Ascensión Antoñana Ugalde, Sonia Hernández Sánchez, Elena del Prado Díaz, Susana Jiménez-Blanco Bravo, Marta Cordero Pereda, David Zamorano Gómez, José Luis Álvarez-García, Jesús Front Cardiovasc Med Cardiovascular Medicine BACKGROUND: Heart Failure (HF) is a growing epidemic with a similar prevalence in men and women. However, women have historically been underrepresented in clinical trials, leading to uneven evidence regarding the benefit of guideline-directed medical therapy (GDMT). This review aims to outline the sex differences in the efficacy of pharmacological and non-pharmacological treatment of HF with reduced ejection fraction (HFrEF). METHODS AND RESULTS: We conducted a systematic review via Medline from inception to 31 January 2022, including all randomized clinical trials published in English including adult patients suffering HFrEF that reported data on the efficacy of each drug. Baseline clinical characteristics, primary outcomes, and sex-specific effects are summarized in tables. The systemic review has been conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. In total, 29 articles were included in the systematic review. We observed that the proportion of women enrolled in clinical trials was generally low, the absence of a prespecified analysis of efficacy by sex was frequent, and the level of quality of evidence on the efficacy of GDMT and implantable cardioverter defibrillator (ICD) or cardiac resynchronization therapy (CRT-) in women was relatively poor. CONCLUSIONS: Sex influences the response to treatment of patients suffering from HFrEF. All the results from the landmark randomized clinical trials are based on study populations composed mainly of men. Further studies specifically designed considering sex differences are warranted to elucidate if GDMT and new devices are equally effective in both sexes. Frontiers Media S.A. 2022-07-25 /pmc/articles/PMC9358690/ /pubmed/35958423 http://dx.doi.org/10.3389/fcvm.2022.921378 Text en Copyright © 2022 Sanromán Guerrero, Antoñana Ugalde, Hernández Sánchez, del Prado Díaz, Jiménez-Blanco Bravo, Cordero Pereda, Zamorano Gómez and Álvarez-García. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Cardiovascular Medicine
Sanromán Guerrero, María Ascensión
Antoñana Ugalde, Sonia
Hernández Sánchez, Elena
del Prado Díaz, Susana
Jiménez-Blanco Bravo, Marta
Cordero Pereda, David
Zamorano Gómez, José Luis
Álvarez-García, Jesús
Role of sex on the efficacy of pharmacological and non-pharmacological treatment of heart failure with reduced ejection fraction: A systematic review
title Role of sex on the efficacy of pharmacological and non-pharmacological treatment of heart failure with reduced ejection fraction: A systematic review
title_full Role of sex on the efficacy of pharmacological and non-pharmacological treatment of heart failure with reduced ejection fraction: A systematic review
title_fullStr Role of sex on the efficacy of pharmacological and non-pharmacological treatment of heart failure with reduced ejection fraction: A systematic review
title_full_unstemmed Role of sex on the efficacy of pharmacological and non-pharmacological treatment of heart failure with reduced ejection fraction: A systematic review
title_short Role of sex on the efficacy of pharmacological and non-pharmacological treatment of heart failure with reduced ejection fraction: A systematic review
title_sort role of sex on the efficacy of pharmacological and non-pharmacological treatment of heart failure with reduced ejection fraction: a systematic review
topic Cardiovascular Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9358690/
https://www.ncbi.nlm.nih.gov/pubmed/35958423
http://dx.doi.org/10.3389/fcvm.2022.921378
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