Review

. 2023 Dec 7;6(2Part B):258-278.

doi: 10.1016/j.cjco.2023.12.001. eCollection 2024 Feb.

The Canadian Women's Heart Health Alliance ATLAS on the Epidemiology, Diagnosis, and Management of Cardiovascular Disease in Women - Chapter 9: Summary of Current Status, Challenges, Opportunities, and Recommendations

Sharon L Mulvagh^{1

2}, Tracey J F Colella^{3

4}, Martha Gulati⁵, Rebecca Crosier⁶, Saleema Allana⁷, Varinder Kaur Randhawa⁸, Jill Bruneau⁹, Christine Pacheco¹⁰, Shahin Jaffer¹¹, Lisa Cotie³, Emma Mensour⁷, Marie-Annick Clavel¹², Braeden Hill¹³, Amy A Kirkham^{3

13}, Heather Foulds¹⁴, Kiera Liblik¹², Andrea Van Damme¹⁵, Sherry L Grace¹⁶, Karen Bouchard⁶, Heather Tulloch⁶, Helen Robert⁶, April Pike⁹, Jamie L Benham¹⁷, Nicole Tegg¹⁸, Nazli Parast⁶, Najah Adreak¹⁹, Laurie-Anne Boivin-Proulx⁶, Monica Parry⁴, Zoya Gomes²⁰, Hope Sarfi²¹, Chinelo Iwegim²², Harriette G C Van Spall²³, Kara A Nerenberg¹⁷, Stephen P Wright¹⁹, Jayneelkumar A Limbachia²⁴, Kerri-Anne Mullen⁶, Colleen M Norris¹⁸

Affiliations

¹ Division of Cardiology, Dalhousie University, Halifax, Nova Scotia, Canada.
² Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.
³ KITE-UHN-Toronto Rehabilitation, Toronto, Ontario, Canada.
⁴ Lawrence S. Bloomberg Faculty of Nursing, Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada.
⁵ Barbra Streisand Women's Heart Center, Cedars Sinai Heart Institute, Los Angeles, California, USA.
⁶ University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
⁷ University of Western Ontario, London, Ontario, Canada.
⁸ Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
⁹ Memorial University, St John's, Newfoundland and Labrador, Canada.
¹⁰ Department of Medicine, University of Montreal, Montreal, Quebec, Canada.
¹¹ Department of Medicine, Division of Community Internal Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
¹² Department of Medicine, Queen's University, Kingston, Ontario, Canada.
¹³ Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada.
¹⁴ College of Kinesiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
¹⁵ University of Alberta Faculty of Graduate & Postdoctoral Studies, Edmonton, Alberta, Canada.
¹⁶ York University and University Health Network, Toronto, Ontario, Canada.
¹⁷ Departments of Medicine, University of Calgary, Calgary, Alberta, Canada.
¹⁸ Faculties of Nursing, Medicine, and School of Public Health, University of Alberta, Edmonton, Alberta, Canada.
¹⁹ University of British Columbia, Vancouver, British Columbia, Canada.
²⁰ Dalhousie University, Halifax, Nova Scotia, Canada.
²¹ Canadian Women's Heart Health Alliance, Ottawa, Ontario, Canada.
²² Fraser Health Authority, Surrey, British Columbia, Canada.
²³ Departments of Medicine and Health Research Methods, Evidence, and Impact, Research Institute of St Joe's, Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada.
²⁴ McMaster University, Hamilton, Ontario, Canada.

PMID: 38487064
PMCID: PMC10935707
DOI: 10.1016/j.cjco.2023.12.001

Review

The Canadian Women's Heart Health Alliance ATLAS on the Epidemiology, Diagnosis, and Management of Cardiovascular Disease in Women - Chapter 9: Summary of Current Status, Challenges, Opportunities, and Recommendations

Sharon L Mulvagh et al. CJC Open. 2023.

. 2023 Dec 7;6(2Part B):258-278.

doi: 10.1016/j.cjco.2023.12.001. eCollection 2024 Feb.

Authors

Affiliations

¹ Division of Cardiology, Dalhousie University, Halifax, Nova Scotia, Canada.
² Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.
³ KITE-UHN-Toronto Rehabilitation, Toronto, Ontario, Canada.
⁴ Lawrence S. Bloomberg Faculty of Nursing, Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada.
⁵ Barbra Streisand Women's Heart Center, Cedars Sinai Heart Institute, Los Angeles, California, USA.
⁶ University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
⁷ University of Western Ontario, London, Ontario, Canada.
⁸ Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
⁹ Memorial University, St John's, Newfoundland and Labrador, Canada.
¹⁰ Department of Medicine, University of Montreal, Montreal, Quebec, Canada.
¹¹ Department of Medicine, Division of Community Internal Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
¹² Department of Medicine, Queen's University, Kingston, Ontario, Canada.
¹³ Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada.
¹⁴ College of Kinesiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
¹⁵ University of Alberta Faculty of Graduate & Postdoctoral Studies, Edmonton, Alberta, Canada.
¹⁶ York University and University Health Network, Toronto, Ontario, Canada.
¹⁷ Departments of Medicine, University of Calgary, Calgary, Alberta, Canada.
¹⁸ Faculties of Nursing, Medicine, and School of Public Health, University of Alberta, Edmonton, Alberta, Canada.
¹⁹ University of British Columbia, Vancouver, British Columbia, Canada.
²⁰ Dalhousie University, Halifax, Nova Scotia, Canada.
²¹ Canadian Women's Heart Health Alliance, Ottawa, Ontario, Canada.
²² Fraser Health Authority, Surrey, British Columbia, Canada.
²³ Departments of Medicine and Health Research Methods, Evidence, and Impact, Research Institute of St Joe's, Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada.
²⁴ McMaster University, Hamilton, Ontario, Canada.

PMID: 38487064
PMCID: PMC10935707
DOI: 10.1016/j.cjco.2023.12.001

Abstract
in English, French

This final chapter of the Canadian Women's Heart Health Alliance "ATLAS on the Epidemiology, Diagnosis, and Management of Cardiovascular Disease in Women" presents ATLAS highlights from the perspective of current status, challenges, and opportunities in cardiovascular care for women. We conclude with 12 specific recommendations for actionable next steps to further the existing progress that has been made in addressing these knowledge gaps by tackling the remaining outstanding disparities in women's cardiovascular care, with the goal to improve outcomes for women in Canada.

Dans ce chapitre final de l’ATLAS sur l’épidémiologie, le diagnostic et la prise en charge de la maladie cardiovasculaire chez les femmes de l’Alliance canadienne de santé cardiaque pour les femmes, nous présentons les points saillants de l’ATLAS au sujet de l’état actuel des soins cardiovasculaires offerts aux femmes, ainsi que des défis et des occasions dans ce domaine. Nous concluons par 12 recommandations concrètes sur les prochaines étapes à entreprendre pour donner suite aux progrès déjà réalisés afin de combler les lacunes dans les connaissances, en s’attaquant aux disparités qui subsistent dans les soins cardiovasculaires prodigués aux femmes, dans le but d’améliorer les résultats de santé des femmes au Canada.

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Figures

**Figure 1**
Summary of challenges, opportunities, and recommendations to further the progress that has been made in addressing the knowledge gaps and disparities in women’s CV care. CR, cardiovascular rehabilitation; CV, cardiovascular; CVD, cardiovascular disease; CWHHA, Canadian Women’s Heart Health Alliance; SCAD, spontaneous coronary artery dissection.

**Figure 2**
(A) Country rankings in terms of total number of women’s cardiovascular health publications (documents). (B) Country rankings in terms of women’s cardiovascular health publications (documents) per 1 million population. (C) Country rankings in terms of women’s cardiovascular health publications (documents) per 1 trillion gross domestic product.

**Figure 3**
Stoplight of action in the various areas of women’s cardiovascular health.

See this image and copyright information in PMC

References

1. Smilowitz N.R., Mahajan A.M., Roe M.T., et al. Mortality of myocardial infarction by sex, age, and obstructive coronary artery disease status in the ACTION Registry-GWTG (Acute Coronary Treatment and Intervention Outcomes Network Registry-Get With the Guidelines) Circ Cardiovasc Qual Outcomes. 2017;10 - PubMed
1. Saw J., Starovoytov A., Aymong E., et al. Canadian spontaneous coronary artery dissection cohort study: 3-year outcomes. J Am Coll Cardiol. 2022;80:1585–1597. - PubMed
1. Safdar B., Spatz E.S., Dreyer R.P., et al. Presentation, clinical profile, and prognosis of young patients with myocardial infarction with nonobstructive coronary arteries (MINOCA): results from the VIRGO study. J Am Heart Assoc. 2018;7 - PMC - PubMed
1. Reynolds H.R., Maehara A., Kwong R.Y., et al. Coronary optical coherence tomography and cardiac magnetic resonance imaging to determine underlying causes of myocardial infarction with nonobstructive coronary arteries in women. Circulation. 2021;143:624–640. - PMC - PubMed
1. Barr P.R., Harrison W., Smyth D., Flynn C., Lee M., Kerr A.J. Myocardial infarction without obstructive coronary artery disease is not a benign condition (ANZACS-QI 10) Heart Lung Circ. 2018;27:165–174. - PubMed

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The Canadian Women's Heart Health Alliance ATLAS on the Epidemiology, Diagnosis, and Management of Cardiovascular Disease in Women - Chapter 9: Summary of Current Status, Challenges, Opportunities, and Recommendations

Affiliations

The Canadian Women's Heart Health Alliance ATLAS on the Epidemiology, Diagnosis, and Management of Cardiovascular Disease in Women - Chapter 9: Summary of Current Status, Challenges, Opportunities, and Recommendations

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Affiliations

Abstract
in English, French

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References

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Abstract in English, French

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Abstract
in English, French