Medical management of anginal symptoms in women with stable angina pectoris: A systematic review of randomised controlled trials

• Published in: International journal of cardiology 2021-10, Vol.341, p.1-8
• Main Authors: Webb, Carolyn M., Collins, Peter
• Format: Article
• Language: English
• Subjects: Controlled trials; Medical management; Stable angina; Women
• ISSN: 0167-5273; 1874-1754
• DOI: 10.1016/j.ijcard.2021.07.018

Medical therapies are used to improve stable anginal symptoms and quality of life in clinical practice however the evidence for the use of antianginal medication in women is largely unknown. We conducted a systematic review to investigate the extent of the evidence-base for the medical management of anginal symptoms in women with stable angina. MEDLINE, EMBASE, Cochrane and ClinicalTrials.gov databases were searched to the end of December 2019. Retrieved papers were hand searched. Included were randomised controlled trials with at least one week of follow-up that included women with stable angina pectoris, with or without significant coronary atherosclerosis, randomised to conventional antianginal medication or/and a comparator, with a primary or secondary endpoint of angina frequency or glyceryl trinitrate (GTN) consumption. A total of 397 eligible publications were included in a qualitative analysis, with women comprising up to 20–30% of the study populations. No publication that included women and men reported all data separately for each sex. Twenty-six publications reported any female data separately from male data but only 18 reported angina data for women, 12 of which included fewer than 10 women. Substantially fewer women than men were included in randomised trials of antianginal medications reporting effects on anginal symptoms, and reporting of data by sex was infrequent. As a result, there is little evidence on which to base treatment recommendations for anginal symptoms in women. Our results provide a platform for future studies to fill this void in the evidence. •First systematic review of randomised trials investigating the medical management of anginal symptoms in women with stable angina.•Women have been included in fewer numbers than men in randomised trials of medications treating stable anginal symptoms.•No publications that included both women and men reported all data separately for each sex.•Currently there is little evidence on which to base medical treatment recommendations for stable anginal symptoms in women.