Revisiting October’s Insights: “Women’s aspects in 2023 ESC Guidelines”
Dive into the heart of women’s cardiovascular health at the session, chaired by Cecilia Linde and Roxana Mehran, focusing on the 2023 ESC Guidelines. Our esteemed panel, including Anna Brzęk, Michał Hawranek, Bartosz Hudzik, and Izabella Uchmanowicz, led discussions across critical areas such as acute coronary syndromes by Vijay Kunadian, cardiomyopathies by Agata Bielecka-Dąbrowa, endocarditis by Jacek Niedziela, cardiovascular disease and diabetes by Maciej Lesiak, and heart failure by Jelena Celutkiene.
Expect to explore the spectrum of acute coronary syndromes with a lens on personalized diagnosis and treatment, emphasizing the unique challenges women face from MINOCA to long-term care. The session will delve into cardiomyopathies, revealing the importance of recognizing different phenotypes and the tailored management required for women, underlined by the critical role of diagnostic algorithms and the significance of diabetes screening. The discussion will not shy away from the complexities of endocarditis and its implications in women, along with an insightful look into how cardiovascular diseases intertwine with diabetes. The lecture on heart failure will shed light on the latest management strategies, particularly relevant to women, and discuss the need for increased representation of women in clinical trials to ensure more inclusive and effective treatment approaches.
Vijay Kunadian: I mentioned to you that ACS is being considered as a full spectrum, consisting of unstable angina, NSTEMI, and STEMI. So, we had a session on MINOCA that really triggered the terminology of working diagnosis, which we introduced in the guidelines. Because most of these patients often present to the cathlabs, and that’s where we’re investigating these people, and the diagnosis may not always be completely evident at the time of presentation, at the time of investigating. And also, to encourage further investigation and to think about invasive management. And then, of course, we are also focusing on secondary prevention and the long-term treatment, in addition to all the treatment strategies that we provide, including anti-thrombotic therapy and revascularization strategies. So, it’s essentially starting from clinical presentation, working diagnosis, further investigation, and ensuring a final diagnosis. So, we’re really not saying, particularly for female patients, that there’s nothing wrong with them; most often, there is something wrong with them, and that is the reason why they are presenting. And I just put this algorithm together: the treatment of a female patient does not just stop in hospital; it’s a continuum, and it is the role of the person who’s treating these patients’ responsibility to make sure that they deal with the patient at the time, of course, before it’s in the hand of the general practitioners. And if they do present to cardiologists, there is an opportunity to ensure that they’re treated with appropriate treatment, but it’s also the long term, up to 12 months and beyond 12 months, to make sure that they are adequately treated. So, again, emphasizing more on the risk factor control: smoking cessation, healthy diet, and particularly focus on lipid-lowering therapy and the control of blood pressure.
