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Article ; Online: Prevalence of Cardiovascular Risk Factors in Women With Obstructive Coronary Disease Requiring Revascularization: A Meta-analysis.

Berbach, Léa / Nelsa Atongfor Nguéfack, Claudia / Potter, Brian J / Pacheco, Christine / Forcillo, Jessica

CJC open

2023 Volume 6, Issue 2Part B, Page(s) 334–346

Abstract: Background: Cardiovascular disease continues to be the primary cause of premature mortality in women, who previously have been overlooked in clinical trials. Several studies showed that women undergoing coronary artery bypass grafting (CABG) and ... ...

Abstract	Background: Cardiovascular disease continues to be the primary cause of premature mortality in women, who previously have been overlooked in clinical trials. Several studies showed that women undergoing coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) present more cardiovascular risk factors at baseline, develop more postprocedural complications, and have a higher mortality rate than men. The goal of this review is to analyze the difference between men and women in terms of the prevalence of individual cardiovascular risk factors. Methods: A meta-analysis was conducted of original investigations with adult subjects who underwent surgical intervention or PCIs in which cardiovascular risk factors were evaluated, using the MEDLINE, Cochrane, Evidence-Based Medicine Reviews (EBMR), Ovid Embase, Google Scholar, and PubMed databases. Results: Of the 4567 identified records found, 18 were retained for qualitative analysis. Prevalence of hypertension (CABG: 71% (95% confidence interval [CI] 64%, 78%]); PCI: (59% [95% CI 48%,70%]), and diabetes (CABG: 48% [95% CI 38%, 57%]); PCI 43% (95% CI 27%, 59%]) was high in women. Women who underwent either CABG or PCI had higher odds of having hypertension (CABG: odds ratio [OR] 1.92 [95% CI 1.47-2.50], Conclusion: The review shows that women who underwent either surgical or percutaneous revascularization had higher odds of hypertension and diabetes, compared to men.
Language	English
Publishing date	2023-11-02
Publishing country	United States
Document type	Journal Article ; Review
ISSN	2589-790X
ISSN (online)	2589-790X
DOI	10.1016/j.cjco.2023.10.016
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: The Thyroid Axis in Peripartum Cardiomyopathy: A Potential Contributor to a Multifaceted Disease.

Tremblay-Gravel, Maxime / Pacheco, Christine

The Canadian journal of cardiology

2019 Volume 35, Issue 6, Page(s) 710–711

MeSH term(s)	Cardiomyopathies ; Female ; Heart Failure ; Humans ; Peripartum Period ; Postpartum Period ; Puerperal Disorders ; Thyroiditis
Language	English
Publishing date	2019-04-26
Publishing country	England
Document type	Editorial ; Research Support, Non-U.S. Gov't ; Comment
ZDB-ID	632813-1
ISSN	1916-7075 ; 0828-282X
ISSN (online)	1916-7075
ISSN	0828-282X
DOI	10.1016/j.cjca.2019.04.019
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Zs.A 2150: Show issues

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Article ; Online: Prehospital STEMI Referral Systems and Sex-Related Bias in Canada: A National Survey.

Boivin-Proulx, Laurie-Anne / Pacheco, Christine / Matteau, Alexis / Mansour, Samer / Potter, Brian J

CJC open

2022 Volume 4, Issue 10, Page(s) 829–832

Abstract: Background: Prehospital electrocardiographic ST-elevation myocardial infarction (STEMI) diagnosis and prehospital cardiac catheterization laboratory activation have been shown to significantly reduce average treatment delay, and further standardization ... ...

Abstract	Background: Prehospital electrocardiographic ST-elevation myocardial infarction (STEMI) diagnosis and prehospital cardiac catheterization laboratory activation have been shown to significantly reduce average treatment delay, and further standardization of such systems may help reduce sex-related treatment and outcome gaps. However, what types of prehospital STEMI activation systems are in place across Canada, and to what extent sex-based STEMI treatment disparities are tracked, is unknown. Methods: We conducted a national survey of catheterization laboratory directors between October 11 and December 25, 2021. Seventeen catheterization laboratory directors representing 6 community and 11 academic centres completed the survey (40% response rate). Results: : All responding centres use a prehospital STEMI diagnosis and cardiac catheterization laboratory activation system, and the majority (59%) rely on real-time physician oversight. Slightly less than half (47%) of percutaneous coronary intervention centres reported prospectively tracking sex-related differences in STEMI care, and only one respondent believed that a significant systemic sex-related bias was present in their prehospital STEMI referral system. Patient factors (symptom description or time to presentation; 23.5%) and limitations of electrocardiogram diagnosis of STEMI in women (23.5%) were cited most frequently as contributing to sex-related bias in STEMI referral systems. In contrast, implicit bias in the referral algorithm, prehospital provider bias, and physician bias were not considered important contributing factors. Conclusions: Although all responding centres employ prehospital activation systems, less than half tracked sex-related differences, and most respondents believed that no sex-related bias existed in their prehospital STEMI system.
Language	English
Publishing date	2022-05-31
Publishing country	United States
Document type	Journal Article
ISSN	2589-790X
ISSN (online)	2589-790X
DOI	10.1016/j.cjco.2022.05.006
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Article ; Online: INOCA and MINOCA: Are Women's Heart Centres the Answer to Understanding and Management of These Increasing Populations of Women (and Men)?

Pacheco, Christine / Luu, Judy / Mehta, Puja K / Wei, Janet / Gulati, Martha / Bairey Merz, C Noel

The Canadian journal of cardiology

2022 Volume 38, Issue 10, Page(s) 1611–1614

MeSH term(s)	Female ; Heart ; Humans ; MINOCA ; Male
Language	English
Publishing date	2022-09-07
Publishing country	England
Document type	Editorial ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Comment
ZDB-ID	632813-1
ISSN	1916-7075 ; 0828-282X
ISSN (online)	1916-7075
ISSN	0828-282X
DOI	10.1016/j.cjca.2022.06.016
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Article ; Online: Women in Cardiovascular Clinical Trials-What Are the Barriers to Address to Improve Enrollment?

Pacheco, Christine / Bairey Merz, C Noel

The Canadian journal of cardiology

2019 Volume 35, Issue 5, Page(s) 552–554

MeSH term(s)	Cardiovascular System ; Female ; Humans ; Patient Selection ; Randomized Controlled Trials as Topic
Language	English
Publishing date	2019-03-29
Publishing country	England
Document type	Editorial ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Comment
ZDB-ID	632813-1
ISSN	1916-7075 ; 0828-282X
ISSN (online)	1916-7075
ISSN	0828-282X
DOI	10.1016/j.cjca.2019.03.018
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Article ; Online: Pathophysiology of Myocardial Infarction With Nonobstructive Coronary Artery Disease: A Contemporary Systematic Review.

Boivin-Proulx, Laurie-Anne / Haddad, Kevin / Lombardi, Marco / Chong, Aun Yeong / Escaned, Javier / Mukherjee, Swati / Forcillo, Jessica / Potter, Brian J / Coutinho, Thais / Pacheco, Christine

CJC open

2023 Volume 6, Issue 2Part B, Page(s) 380–390

Abstract: Background: Myocardial infarction with nonobstructive coronary artery disease (MINOCA) is defined as acute myocardial infarction (AMI) with angiographically nonobstructive coronary artery disease. MINOCA represents 6% of all AMI cases and is associated ... ...

Abstract	Background: Myocardial infarction with nonobstructive coronary artery disease (MINOCA) is defined as acute myocardial infarction (AMI) with angiographically nonobstructive coronary artery disease. MINOCA represents 6% of all AMI cases and is associated with increased mortality and morbidity. However, the wide array of pathophysiological factors and causes associated with MINOCA presents a diagnostic conundrum. Therefore, we conducted a contemporary systematic review of the pathophysiology of MINOCA. Methods: A comprehensive systematic review of MINOCA was carried out through the utilization of the PubMed database. All systematic reviews, meta-analyses, randomized controlled trials, and cohort studies available in English or French that reported on the pathophysiology of MINOCA published after January 1, 2013 were retained. Results: Of the 600 identified records, 80 records were retained. Central to the concept of MINOCA is the definition of AMI, characterized by the presence of myocardial damage reflected by elevated cardiac biomarkers in the setting of acute myocardial ischemia. As a result, a structured approach should be adopted to thoroughly assess and address clinically overlooked obstructive coronary artery disease, and cardiac and extracardiac mechanisms of myocyte injury. Once these options have been ruled out, a diagnosis of MINOCA can be established, and the appropriate multimodal assessment can be conducted to determine its specific underlying cause (plaque disruption, epicardial coronary vasospasm, coronary microvascular dysfunction, and coronary embolism and/or spontaneous coronary dissection or supply-demand mismatch). Conclusions: Integrating a suitable definition of AMI and understanding the pathophysiological mechanisms of MINOCA are crucial to ensure an effective multimodal diagnostic evaluation and the provision of adequate tailored therapies.
Language	English
Publishing date	2023-11-18
Publishing country	United States
Document type	Journal Article ; Review
ISSN	2589-790X
ISSN (online)	2589-790X
DOI	10.1016/j.cjco.2023.11.014
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Article: Sex-Specific Physiology and Cardiovascular Disease.

Shufelt, Chrisandra L / Pacheco, Christine / Tweet, Marysia S / Miller, Virginia M

Advances in experimental medicine and biology

2018 Volume 1065, Page(s) 433–454

Abstract: Sex differences in cardiovascular diseases can be classified as those which are specific to one sex and those that differ in incidence, prevalence, etiology, symptomatology, response to treatment, morbidity, and mortality in one sex compared to the other. ...

Abstract	Sex differences in cardiovascular diseases can be classified as those which are specific to one sex and those that differ in incidence, prevalence, etiology, symptomatology, response to treatment, morbidity, and mortality in one sex compared to the other. All sex differences in cardiovascular conditions have their basis in the combined expression of genetic and hormonal differences between women and men. This chapter addresses how understanding basic mechanisms of hormone responses, imaging diagnostics, and integration of genomics and proteomics has advanced diagnosis and improved outcomes for cardiovascular conditions, apart from those related to pregnancy that are more prevalent in women. These conditions include obstructive coronary artery disease, coronary microvascular dysfunction, spontaneous coronary artery dissection, diseases of the cardiac muscle including heart failure and takotsubo cardiomyopathy, and conditions related to neurovascular dysregulation including hot flashes and night sweats associated with menopause and effects of exogenous hormones on vascular function. Improvement in technologies allowing for noninvasive assessment of neuronally mediated vascular reactivity will further improve our understanding of the basic etiology of the neurovascular disorders. Consideration of sex, hormonal status, and pregnancy history in diagnosis and treatment protocols will improve prevention and outcomes of cardiovascular disease in women as they age.
MeSH term(s)	Animals ; Autonomic Nervous System/physiopathology ; Cardiovascular Diseases/diagnosis ; Cardiovascular Diseases/epidemiology ; Cardiovascular Diseases/physiopathology ; Cardiovascular Diseases/therapy ; Cardiovascular System/innervation ; Coronary Circulation ; Estrogen Replacement Therapy/adverse effects ; Female ; Health Status Disparities ; Hemodynamics ; Humans ; Male ; Menopause ; Risk Factors ; Sex Characteristics ; Sex Factors ; Ventricular Function
Language	English
Publishing date	2018-07-23
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	410187-X
ISSN	0065-2598
ISSN	0065-2598
DOI	10.1007/978-3-319-77932-4_27
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Zs.A 3192: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Letter by Pacheco et al Regarding Article, "Proton Pump Inhibitors, Platelet Reactivity, and Cardiovascular Outcomes After Drug-Eluting Stents in Clopidogrel-Treated Patients: The ADAPT-DES Study".

Pacheco, Christine / Aguilar, Martin / Potter, Brian J

Circulation. Cardiovascular interventions

2016 Volume 9, Issue 3, Page(s) e003499

MeSH term(s)	Blood Vessel Prosthesis Implantation ; Drug-Eluting Stents/utilization ; Female ; Humans ; Male ; Postoperative Complications/prevention & control ; Proton Pump Inhibitors/therapeutic use ; Ticlopidine/analogs & derivatives
Chemical Substances	Proton Pump Inhibitors ; Ticlopidine (OM90ZUW7M1)
Language	English
Publishing date	2016-03
Publishing country	United States
Document type	Comment ; Letter
ZDB-ID	2450797-0
ISSN	1941-7632 ; 1941-7640
ISSN (online)	1941-7632
ISSN	1941-7640
DOI	10.1161/CIRCINTERVENTIONS.115.003499
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Zs.A 6746: Show issues

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Article ; Online: HIV in Pregnancy.

Roth, Cheryl / Hrenchir, Pauline F / Pacheco, Christine J

Nursing for women's health

2016 Volume 20, Issue 1, Page(s) 87–91

Abstract: In the United States, women with HIV have the ability to make informed choices relating to their reproductive lives more now than ever before. The increasing availability of antiretroviral therapy has spurred renewed interest among many HIV-positive ... ...

Abstract	In the United States, women with HIV have the ability to make informed choices relating to their reproductive lives more now than ever before. The increasing availability of antiretroviral therapy has spurred renewed interest among many HIV-positive women in their decisions about whether to have children. It is important for perinatal nurses to understand the maternal and fetal implications of HIV in pregnancy, including parameters for treatment and the drug regimens typically used during the antepartum, intrapartum, and postpartum periods.
MeSH term(s)	Adolescent ; Adult ; Anti-HIV Agents/therapeutic use ; Female ; HIV Infections/complications ; HIV Infections/drug therapy ; HIV Infections/nursing ; HIV Infections/transmission ; Humans ; Infectious Disease Transmission, Vertical ; Middle Aged ; Obstetric Nursing/standards ; Practice Guidelines as Topic ; Pregnancy ; Pregnancy Complications, Infectious/drug therapy ; Pregnancy Complications, Infectious/nursing ; Pregnancy Complications, Infectious/prevention & control ; Pregnancy Complications, Infectious/virology ; United States ; Young Adult
Chemical Substances	Anti-HIV Agents
Language	English
Publishing date	2016-02
Publishing country	United States
Document type	Journal Article
ZDB-ID	2275619-X
ISSN	1751-486X ; 1751-4851
ISSN (online)	1751-486X
ISSN	1751-4851
DOI	10.1016/j.nwh.2015.12.010
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Zs.A 4732: Show issues

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Article ; Online: Spontaneous Coronary Artery Dissection Across the Health Care Pathway: A National, Multicenter, Patient-Informed Investigation.

Bouchard, Karen / Lalande, Kathleen / Coutinho, Thais / Mulvagh, Sharon / Pacheco, Christine / Liu, Shuangbo / Saw, Jacqueline / So, Derek / Reed, Jennifer L / Chiarelli, Alexandra / Stragapede, Elisa / Robert, Helen / Lappa, Nadia / Sun, Louise / Wells, George / Tulloch, Heather

Journal of the American Heart Association

2023 Volume 12, Issue 24, Page(s) e032141

Abstract: Background: Clinical practice guidelines for the management and convalescence of patients with spontaneous coronary artery dissection (SCAD) have yet to be developed. The targeted content, delivery, and outcomes of interventions that benefit this ... ...

Abstract	Background: Clinical practice guidelines for the management and convalescence of patients with spontaneous coronary artery dissection (SCAD) have yet to be developed. The targeted content, delivery, and outcomes of interventions that benefit this population remain unclear. Patient-informed data are required to substantiate observational research and provide evidence to inform and standardize clinical activities. Methods and results: Patients diagnosed with SCAD (N=89; 86.5% women; mean age, 53.2 years) were purposively selected from 5 large tertiary care hospitals. Patients completed sociodemographic and medical questionnaires and participated in an interview using a patient-piloted semistructured interview guide. Interviews were transcribed and subjected to framework analysis using inductive and then deductive coding techniques. Approximately 1500 standard transcribed pages of interview data were collected. Emotional distress was the most commonly cited precipitating factor (56%), with an emphasis on anxiety symptoms. The awareness and detection of SCAD as a cardiac event was low among patients (35%) and perceived to be moderate among health care providers (55%). Health care providers' communication of the prognosis and self-management of SCAD were perceived to be poor (79%). Postevent psychological disorders among patients were evident (30%), and 73% feared recurrence. Short- and longer-term follow-up that was tailored to patients' needs was desired (72%). Secondary prevention programming was recommended, but there were low completion rates of conventional cardiac rehabilitation (48%), and current programming was deemed inadequate. Conclusions: This early-stage, pretrial research has important implications for the acute and long-term management of patients with SCAD. Additional work is required to validate the hypotheses generated from this patient-oriented research.
MeSH term(s)	Humans ; Female ; Middle Aged ; Male ; Coronary Vessels ; Critical Pathways ; Vascular Diseases/diagnosis ; Vascular Diseases/epidemiology ; Vascular Diseases/therapy ; Prognosis ; Coronary Angiography/methods ; Risk Factors
Language	English
Publishing date	2023-12-12
Publishing country	England
Document type	Multicenter Study ; Journal Article
ZDB-ID	2653953-6
ISSN	2047-9980 ; 2047-9980
ISSN (online)	2047-9980
ISSN	2047-9980
DOI	10.1161/JAHA.123.032141
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