Despite that cardiovascular disease (CVD) is the main cause of death in women worldwide and that the existent evidence that women with CVD differs from men with the same diseases from many views including pathophysiological to therapeutic. Yet, there is an unmet need for registries focused on sex differences in CVD, as the first step toward patient-centered trials, guidelines, and protocols. To the best of our knowledge, there has been no prior registry focusing exclusively on CVD in women with sex-focused research questions and methodology thus far.
The Iraqi Registry of Cardiovascular Diseases in Women (IROCW) recruits women who were admitted to the included centers in Iraq. IROCW includes different cardiovascular diseases which are ischemic heart disease, valvular heart disease, heart failure (HF), and arrhythmias. In this paper, we included the results of the pilot phase that was designed and implemented to ensure the feasibility of a large-scale sex-specific cardiovascular registry in Iraq.
The pilot phase included 150 patients, mean age was 60 years, and 89.3% of patients resided in urban areas. 60% of the women’s family total income was <500 USD. The most common cardiac risk factor is hypertension while menopause and gestational hypertension are the most common sex-specific risk factors. In-hospital echocardiography was done in 26%. In-hospital HF was reported in 20% of patients. Aspirin, P2Y12 inhibitors, heparin, and statin were used in 85.8%, 60.4%, 35.4%, and 87.9%, respectively. B-blockers, angiotensin-converting enzyme inhibitor (ACEI)/angiotensin receptor blockers (ARBs), and mineralocorticoid receptor antagonist (MRA) were used in 71.1%, 62.8%, and 7.2% respectively. Dietary instructions as indicated on discharge were done properly in 96.6%, while smoking cessation counseling and referral for cardiac rehabilitation were not done properly in daily practice. 78% of our pilot population were reachable at 1-month follow-up.
Up to our knowledge, the IROCW registry is the first sex-focused methodology cardiac registry that will bridge the knowledge gap in clinical characteristics, diagnostic parameters, and management plans in women with CVD, and it will also assess the prognostic benefit of different guideline-directed medical therapies; specifically in women, an issue that is not settled in existing literature. If the second large cohort of IROCW is achieved as planned, it will generate data that can help in establishing a roadmap to decrease the CVD burden in women in Iraq.
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