Evidence map›Paper›PMID 41923740›Full record

SynthesisReviews in cardiovascular medicine2026

Representation of Women in Atrial Fibrillation Clinical Trials: A Systematic Review.

Ramzi Ibrahim, Hoang Nhat Pham, Christopher Kanaan, Buthainah Alhwarat, Enkhtsogt Sainbayar, Sabrina Soin, Chadi Ayoub, Alaide Chieffo, Garima Sharma, Jo Protheroe and 4 more

Abstract readSystematic Review
In one paragraph

Synthesis in Reviews in cardiovascular medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Ramzi IbrahimDepartment of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ 85054, USA.ORCID https://orcid.org/0009-0003-1690-3845
Hoang Nhat PhamDepartment of Medicine, University of Arizona, Tucson, AZ 85721, USA.ORCID https://orcid.org/0000-0001-8412-0082
Christopher KanaanDepartment of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ 85054, USA.ORCID https://orcid.org/0009-0002-3814-3501
Buthainah AlhwaratDepartment of Medicine, University of Arkansas, Little Rock, AR 72205, USA.
Enkhtsogt SainbayarDepartment of Medicine, University of Arizona, Tucson, AZ 85721, USA.ORCID https://orcid.org/0009-0001-7338-2172
Sabrina SoinDepartment of Medicine, University of Arizona, Tucson, AZ 85721, USA.
Chadi AyoubDepartment of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ 85054, USA.ORCID https://orcid.org/0000-0001-5877-7478
Alaide ChieffoUniversità Vita-Salute San Raffaele, 20132 Milan, Italy.ORCID https://orcid.org/0000-0002-3505-9112
Garima SharmaInova Schar Heart and Vascular, Inova Health System, Falls Church, VA 22042, USA.ORCID https://orcid.org/0000-0003-1056-3766
Jo ProtheroeResearch Department of Primary Care and Population Health, University College London, W1T 6QR London, UK.ORCID https://orcid.org/0000-0002-9608-1487
Justin Z LeeDepartment of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH 44195, USA.ORCID https://orcid.org/0000-0003-2823-9243
Reza ArsanjaniDepartment of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ 85054, USA.ORCID https://orcid.org/0000-0001-7081-4286
Kwan LeeDepartment of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ 85054, USA.ORCID https://orcid.org/0000-0001-6302-9925
Mamas A MamasKeele Cardiovascular Research Group, Keele University, ST5 5BG Newcastle, UK.ORCID https://orcid.org/0000-0001-9241-8890

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Disparities exist in the representation of genders in cardiovascular clinical trials. Atrial fibrillation (AF) is associated with significant morbidity and mortality; however, understanding regarding the representation of women in AF-related clinical trials remains limited. Therefore, this systematic review sought to evaluate the representation of women in AF-related clinical trials. Methods: We conducted a systematic review of clinical trials using the PubMed, Scopus, and EMBASE databases from 1996 to January 1st, 2024, focusing on AF-related lifestyle interventions, pharmacological treatments, catheter ablation, and device therapies for AF. Data extraction and analysis encompassed trial characteristics, participant demographics, and funding sources. The primary outcome was the prevalence of female enrollees, quantified through participation-to-prevalence ratios (PPRs). This was estimated overall and stratified by funding source, intervention type, and enrollment region. Results: Of the 103 clinical trials involving 218,322 participants (39.5% female), the PPR ranged from 0.00 to 1.73, with an average PPR of 1.03. Meanwhile, 43% of the trials exhibited female under-representation (PPR, <0.8). University-funded trials showed higher female enrollment (mean PPR, 0.951) compared to industry/government-funded trials (mean PPR, 0.800). No differences were observed in the representation of women when comparing enrollment regions or intervention types. Conclusions: Despite advancements in AF management, gender disparities persist in AF-related clinical trial representation, particularly in industry/government-funded studies compared to university-funded trials. Thus, addressing implicit biases and enforcing sex equality guidelines are critical steps toward more inclusive cardiovascular research.

Indexed as

atrial fibrillationequitysex disparities

Identifiers

PMID41923740
PMCPMC13036515

What OpenQuestion holds

Textmetadata
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.