Author Response to “Referring Women for Advanced Heart Failure Therapies: Too Little, Too Late”

We thank DeFillipis et al 1 Herr JJ Ravichandran A Sheikh FH et al. Practices of referring patients to advanced heart failure centers. J Card Fail. 2021; 27: 2361-2369 Abstract Full Text Full Text PDF Scopus (3) Google Scholar for their insightful comments regarding our recent publication. Gender disparities exist among patients undergoing evaluation for or receiving advanced heart failure (HF) therapies. Women continue to represent a minority of patients included in clinical trials, most recently seen in the MOMENTUM 3 trial wherein only 19.9% of study participants were female. 2 Mehra MR Goldstein DJ Uriel N et al. Two-year outcomes with a magnetically levitated cardiac pump in heart failure. N Engl J Med. 2018; 378: 1386-1395 Crossref PubMed Scopus (442) Google Scholar We agree that an important question remains whether this is a function of women being less likely to be accepted for advanced HF therapies or an issue of lack of referral. Referring Women for Advanced Heart Failure Therapies: Too Little, Too LateJournal of Cardiac FailureVol. 28Issue 4PreviewIn reviewing multicenter randomized clinical trials for patients with heart failure with reduced ejection fraction (HFrEF) as well as registry reports of left ventricular assist device (LVAD) implants and heart transplantation (HT), there is 1 stark commonality: the low percentage of women enrolled. Women account for 54% of deaths due to heart failure but make up only 21% of LVAD recipients1 and 25% of HT waitlist candidates.2 The cumulative incidence of HFrEF begins to rise at an earlier age in men than in women, but a close look by decade of life suggests that more women should be considered for advanced HF therapies. Full-Text PDF