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J Thorac Cardiovasc Surg 2003;126:936-938
© 2003 The American Association for Thoracic Surgery
Editorial |
a Washington University School of Medicine, St Louis, Mo, USA
b University of Toronto, Toronto, Ontario, Canada
c Washington Hospital Center, Washington, DC, USA
Received for publication March 25, 2003; accepted for publication April 24, 2003.
* Address for reprints: Jennifer S. Lawton, MD, One Barnes Jewish Hospital Plaza, Queeny Tower Suite 3108, St Louis, MO 63131, USA
lawtonj@msnotes.wustl.edu
| The first 300 words of the full text of this article appear below. |
Cardiovascular disease (CVD) is the leading cause of morbidity and mortality for women in the United States, Canada, and most developed countries. In developing countries it will be the leading cause of death in the next 20 years. It is a costly disease both in terms of health care dollars spent and patient lives. Approximately 250,000 women die each year in the United States, and women are 3 times as likely to die of CVD as they are of breast cancer.1 With the publication 10 years ago of 2 sentinel studies detailing the differences between men and women in the delivery of care to patients with CVD, there has been an increased awareness in the health care community and the lay public of issues relevant to the assessment and management of CVD in women.2,3 Perception of CVD by both communities is still evolving and is often influenced by insufficient or, worse, inaccurate information. The androcentric focus of much of cardiovascular research contributes to this problem. Only recently have women been included in sufficient numbers in clinical trials and databases or has there been a requirement for sex-based analysis of data such that specific information pertaining to results in women has been available.3-5 The problem is compounded when trying to analyze the results of coronary artery bypass grafting (CABG) in women because only 30% of all CABG operations are performed on women and fewer women than men are referred for operation, resulting in small sample sizes.6
Numerous studies have demonstrated increased hospital mortality after CABG in women when compared with men.7-9 Increased mortality in women in these studies has often been attributed to referral bias, smaller vessels, decreased body size, and an increased incidence of comorbidities.10-13 More recently, studies suggest that despite the obvious premorbid differences between men and women, women
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