Abstract
Women remain severely underrepresented in clinical trials, leading to a significant disparity in clinical care and outcome among male vs female patients with advanced heart failure (HF). Sex-specific disparities regarding the etiology of HF, time to diagnosis, severity of disease at time of index hospitalization, response to treatment, and treatment options, including use of temporary or durable mechanical circulatory support devices, may affect women unfavourably. Lack of knowledge regarding sex-specific complications has had an impact on the overall higher mortality level in women vs men. Increasing the awareness regarding this sex-specific imbalance is imperative. The inclusion of women in clinical mechanical circulatory support trials is critical, to improve female patient outcomes in stage D HF with reduced ejection fraction.