SCAI Releases New Statement on Sex-Based Considerations in Myocardial Revascularization

Alexandra Lansky, MD

The Society for Cardiovascular Angiography and Interventions (SCAI) has released a new expert consensus statement providing clinicians with sex-specific considerations in myocardial revascularization.

Composed with the aim of summarizing available literature on myocardial revascularization in women and identify research gaps, the 13-page statement outlines contemporary knowledge of sex-based diagnosis and management strategies as well as highlighting diagnosis, outcomes, and procedural-based evidence gaps hampering optimal management.

“This consensus is an international collaborative effort that highlights the knowns, the gaps and ambiguities in evidence related to sex-specific revascularization,” said writing group chair Alexandra Lansky, MD, professor of medicine in the section of Cardiology at the Yale School of Medicine and Editor-in-Chief of the Journal of the Society for Cardiovascular Angiography & Interventions, in a statement. “As a companion to the recent percutaneous coronary intervention (PCI) guidelines, it will inform clinicians on best practices most relevant to our female patients and draws attention to areas in need of additional evidence.”

The statement, which was published on February 4, 2022, details sex-related differences in pathophysiology of myocardial ischemia in women and men and discusses challenges of diagnosis due to sex-related differences in clinical presentation and limitations of imaging. The statement also provides perspective on the consequences of sex-related differences in coronary anatomy and plaque morphology for diagnosis and treatment, challenges related to increased prevalence of comorbidities and bleeding risk, and poorer outcomes in women with coronary artery disease.

Statement authors also outlined multiple knowledge gaps related to diagnosis, procedures, and outcomes.

“Physicians can use this consensus document to inform their discussions with female patients on the risks and benefits of coronary revascularization,” said J. Dawn Abbott, MD, FSCAI, Co-Chair of the document and Professor of Medicine and Director of the Interventional Cardiology Fellowship Training Program at Brown Medical School. “An understanding of the limitations of the data is important in this regard.”

This statement, “SCAI Expert Consensus Statement on Sex-Specific Considerations in Myocardial Revascularization,” was published in the Journal of the Society for Cardiovascular Angiography & Interventions.