Stroke Risk Emphasized in Atrial Fibrillation Guidelines

Abstract

Taking a more cautious approach to the novel testing and significance of coronary microvascular syndrome is Rita Redberg, MD, director of women’s cardiovascular services at the University of San Francisco Medical Center. Redberg noted that much of the current theory surrounding heart disease in women and the significance of new diagnostic testing comes from interim findings from the WISE study, which just concluded in May. Those findings were summed up in a special supplement to the Journal of the American College of Cardiology, released in February (J Am Coll Cardiol. 2006;47[suppl]:1S-71S). “The women in WISE were a fairly select cohort, and we don’t know how that truly translates to the general population,” Redberg said. “It’s certainly possible 3 million women have coronary microvascular syndrome, but the significance of it is not known and needs to be studied.” Redberg also cautioned that the syndrome is also present in some men and that because classic cardiovascular symptoms still affect most heart patients, physicians should not abandon traditional cardiac diagnosis. Douglas and Bairey Merz agree, but they emphasize that further investigation into gender differences is warranted. Therefore, Douglas, Bairey Merz, and Redberg will host a meeting on March 8-9 in Washington, DC, to develop a game plan for future research and guidelines development. “We want to try to understand, based on the data we do have on women, whether we should be caring for women differently than men,” Douglas said, noting researchers do not know whether treating coronary microvascular syndrome will reduce mortality and morbidity. And while understanding a new syndrome and developing novel testing may be exciting, researchers should not ignore prevention, Redberg added. “We still have a long way to go on the basic risk factors.” Stroke Risk Emphasized in Atrial Fibrillation Guidelines