EQUITY IN TIMELY TREATMENT FOR WOMEN WITH CARDIAC DISEASE

Purpose/Aims: More than 233,000 or one in four women die each year due to cardiac disease. The purpose of this presentation is to introduce a cardiac risk stratification tool to assist practitioners in identifying  acute and prodromal symptoms in women increasing quality care and patient safety.

Rationale/Background: Men have benefitted more than women with advances in cardiac disease diagnostics. In the United States, women die of cardiac disease more frequently than men.  This is especially troubling when, compared to women, men present with more acute myocardial infarctions. Cardiovascular disease is still the leading cause of mortality and morbidly for women. Women under 50 years of age have twice the mortality of men after an acute myocardial infarction and women have a higher incidence of sudden cardiac death. These disparities may be the result of a delay in treatment by practitioners who do not recognize prodromal symptoms or their importance in risk stratification. This component is a modifiable factor in decreasing the disparity in mortality and morbidity of women. Furthermore, this disparity expands ethnic lines including Black and Hispanic women having greater disparity over White women in cardiac event recognition and timely treatment.

Description of the Undertaking/Best Practice: A standardized tool that assists practitioners to identify and efficiently treat women with cardiac disease may decrease disparities between men and women and increase patient safety and quality. The tool will provide stratification of women’s cardiovascular acute and prodromal symptoms assisting the practitioner’s ability to categorize cardiac risk and initiate cardiac diagnostic and treatment pathways. Using gender specific risk stratification along with cluster analysis of acute and prodromal symptoms, risk groups will be established. Specific characteristics such as body mass index, race, smoking, age and personal history of cardiovascular disease will be incorporated. 

Practice Outcomes: This tool will be implemented in a clinical practice as part of a quality improvement project.  Our anticipated outcomes include provider and patient satisfaction and effective decision making in assessment and timely treatment of women who present with acute and prodromal cardiac symptoms.

Conclusions: Women are still subject to gender inequities by being under-diagnosis and under-treated. Women who present with prodromal cardiac symptoms challenge practitioners. Research in gender inequities and prodromal clustering can assist practitioners in reaching a cardiac etiology earlier. Early application of risk stratifications are a pivotal link between patient presentation and treatment initiation timelines. Applying a standardized tool will decrease gender inequities in treatment, improving mortality and morbidly for women.