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Background Gender disparities in the management of dysglycaemia, defined as either impaired glucose tolerance (IGT) or type 2 diabetes (T2DM), in coronary artery disease (CAD) patients are a medical challenge. Recent data from two nationwide cohorts of patients suggested no gender difference as regards the risk for diabetes-related CV complications but indicated the presence of a gender disparity in risk factor management. The aim of this study was to investigate gender differences in screening for dysglycaemia, cardiovascular risk factor management and prognosis in dysglycemic CAD patients. Methods The study population (n = 16,259; 4077 women) included 7998 patients from the ESC-EORP EUROASPIRE IV (EAIV: 2012–2013, 79 centres in 24 countries) and 8261 patients from the ESC-EORP EUROASPIRE V (EAV: 2016–2017, 131 centres in 27 countries) cross-sectional surveys. In each centre, patients were investigated with standardised methods by centrally trained staff and those without known diabetes were offered an oral glucose tolerance test (OGTT). The first of CV death or hospitalisation for non-fatal myocardial infarction, stroke, heart failure or revascularization served as endpoint. Median follow-up time was 1.7 years. The association between gender and time to the occurrence of the endpoint was evaluated using Cox survival modelling, adjusting for age. Results Known diabetes was more common among women (32.9%) than men (28.4%, p Conclusions Guideline-recommended risk factor control is poorer in dysglycemic women than men. This may contribute to the worse prognosis in CAD women with known diabetes.

This study is aimed at investigating gender differences in the medical management of patients with coronary heart disease (CHD). Analyses were based on the ESC EORP EUROASPIRE V (European Survey Of Cardiovascular Disease Prevention And Diabetes) survey. Consecutive patients between 18 and 80 years, hospitalized for a coronary event, were included in the study. Information on cardiovascular medication intake at hospital discharge and at follow-up (≥ 6 months to 0.01) at discharge and follow-up respectively. However, a statistically significant difference was found in the use of statins at follow-up, in disfavor of women (82.8% vs. 77.7%; P 0.01). Furthermore, women were less likely than men to have received a CABG (20.4% vs. 13.2%; P

ObjectivePeople’s socioeconomic status (SES) has a major impact on the risk of atherosclerotic cardiovascular disease (ASCVD) in primary prevention. In patients with existing ASCVD these associations are less documented. Here, we evaluate to what extent SES is still associated with patients’ risk profile in secondary prevention.MethodsBased on results from a large sample of patients with coronary heart disease from the European Action on Secondary and Primary Prevention through Intervention to Reduce Events study, the relationship between SES and cardiovascular risk was examined. A SES summary score was empirically constructed from the patients’ educational level, self-perceived income, living situation and perception of loneliness.ResultsAnalyses are based on observations in 8261 patients with coronary heart disease from 27 countries. Multivariate logistic regression analyses demonstrate that a low SES is associated (OR, 95% CI) with lifestyles such as smoking in men (1.63, 1.37 to 1.95), physical activity in men (1.51, 1.28 to 1.78) and women (1.77, 1.32 to 2.37) and obesity in men 1.28 (1.11 to 1.49) and women 1.65 (1.30 to 2.10). Patients with a low SES have more raised blood pressure in men (1.24, 1.07 to 1.43) and women (1.31, 1.03 to 1.67), used less statins and were less adherent to them. Cardiac rehabilitation programmes were less advised and attended by patients with a low SES. Access to statins in middle-income countries was suboptimal leaving about 80% of patients not reaching the low-density lipoprotein cholesterol target of ConclusionThese results illustrate the complexity of the associations between SES, well-being and secondary prevention in patients with ASCVD. They emphasise the need for integrating innovative policies in programmes of cardiac rehabilitation and secondary prevention.

Aims This study aims to provide an overview on contemporary gender differences in the risk factor control of coronary heart disease (CHD) patients. Methods and results Analyses were based on the cross-sectional ESC (European Society of Cardiology) EORP (EurObservational Research Programme) EUROASPIRE V (European Survey of Cardiovascular Disease Prevention and Diabetes) survey including data on CHD patients across 27 European countries. Men and women between 18 and 80 years old, hospitalized for a first or recurrent coronary event were included in the study. Data were available for 8261 patients of which 25.8% women. Overall, women had a worse risk factor control compared with men. Whereas women were more likely to be non-smokers (79.3% vs. 87.2%; P 0.05). Moreover, a lower proportion of women reached low-density lipoprotein cholesterol (LDL-C) target levels (31.4% vs. 22.1%; P Conclusion The risk factor control of CHD women is substantial worse compared with men despite little gender differences in cardiovascular medication intake. Further actions are needed to increase the awareness of the worse risk factor control in female CHD patients.

Background Impaired health-related quality of life (HRQoL) is related to increased morbidity and mortality among coronary heart disease (CHD) patients. Although gender differences in HRQoL have been observed in the general population, the magnitude of gender differences tends to be more pronounced in CHD patients. In addition, a higher comorbidity burden, common in CHD patients, is known to result in an even worse HRQoL outcome. Purpose The aim of this study is to evaluate HRQoL- gender differences among CHD patients and to explore its relationship with comorbidity burden. Methods Analyses were based on the most recent ESC EORP EUROASPIRE V survey data, including patient information from 27 European countries. Consecutive patients (18–80 years), hospitalized for a coronary event or surgical procedure were recruited in the survey. Data presented here were obtained from medical records and standardized patient interviews (6 months to 2 years following hospital discharge). Mean EQ-5D-5L index scores were used to evaluate patients' self-reported health status. A history of stroke, heart failure, peripheral artery disease (PAD), chronic kidney disease (CKD), and self-reported diabetes were considered as comorbidities. Generalized linear mixed models were fitted accounting for clustering of patients within countries and adjusted for age. To investigate the interplay of gender with comorbidities, two-way interaction terms were included. Results Data was available for 8,261 patients, including 25.8% women. Women were slightly older than men (65.4 vs 63.0 years) and more likely to have a history of stroke (5.3% vs. 3.7%; p=0.04), heart failure (7.6% vs. 5.9%; p=0.02), and self-reported diabetes (33.1% vs. 28.0%; p Conclusion Women reported a worse HRQoL compared to men. Further quantitative and qualitative research is needed to understand the gender-differential in HRQoL. Funding Acknowledgement Type of funding sources: Public Institution(s). Main funding source(s): Fonds voor hartchirurgie - Fonds pour la Chirurgie Cardiaque

Background Although heart failure (HF) patients often consider sexual activity as an essential aspect of their quality of life (QoL) and are usually uncertain if it is safe to perform sexual activity, this topic is overall poorly addressed in clinical practice. Aims The aim of this study was to explore the perceptions and practices of Flemish caregivers. Methods Healthcare providers were recruited through convenience sampling and filled in an adapted version of the UNITE Sexual Counselling Instrument. Several relevant network structures in Flanders were used to distribute the questionnaires-online as well as on paper-to healthcare workers being involved in the care to HF patients. Results Results of 180 participants indicated that 51.5% of the healthcare providers have never provided sexual counselling in HF patients. Being male, having a masters' degree, having more than 10 years of experience in cardiovascular disease, working in an ambulatory care department and having more positive attitudes were independently associated with a higher provision of sexual counselling in practice. Conclusion Although healthcare providers perceive it as their responsibility to discuss patients' sexual concerns, these issues are not often addressed in daily practice. Increasing knowledge in healthcare providers and specific practical training in providing information on sexual activity in HF patients are recommended. Further studies are needed to investigate how sexual counselling can be provided in agreement with HF patients' expectations and needs.

Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): Fonds voor hartchirurgie - Fonds pour la Chirurgie Cardiaque OnBehalf EUROASPIRE studygroup BACKGROUND Although previous EUROASPIRE (European Survey Of Cardiovascular Disease Prevention And Diabetes) findings suggest only limited gender differences in the medication intake of coronary patients, the CVD risk factor profile in women remains suboptimal compared to men. Therefore, to further lower the risk of subsequent cardiovascular events, lifestyle behaviour in secondary prevention is crucial. Little is known about gender differences in prescribed lifestyle and patient compliance in tackling lifestyle related risk factor targets. PURPOSE The aim of this study is to identify gender differences in lifestyle prescription and lifestyle compliance after a coronary event. METHODS Analyses were carried out on the ESC EORP EUROASPIRE V survey data, including information from coronary patients recruited in 27 European countries. Consecutive patients RESULTS Data was available for 8261 patients of which 25.8% were women. The mean (SD) age at interview was 62.9 (9.7) years for men and 65.4 (9.2) for women. Overall, no gender differences were observed in smoking cessation advice (85.2% vs. 84.5%; P = 0.90) and in smokers’ attempts to quit smoking (62.6% vs. 63.9%; P= 0.58). Also, no gender differences were observed in dietary advice (85.5% vs. 84.9%; P= 0.32) and in attempts to adopt a healthier diet (87.1% vs. 88.4%; P= 0.14). In contrast, although no gender differences were seen in weight changes among obese patients (60.1% vs. 58.2%; P = 0.49), women were less likely to receive advice on losing weight (75.1% vs. 71.6%; P = 0.02). Interestingly, the latter findings were driven by educational level. Women with a low education level were less likely to receive weight loss advice (71.8% vs. 52.9%; P CONCLUSION These findings suggest worse lifestyle prescription and lifestyle changes for physical activity in women and worse weight loss prescription and weight loss compliance in low educated but not highly educated women. Specific attention should be given to women with a low educational level. Further quantitative and qualitative research is needed to understand the gender gap in lifestyle management.

Background Previously, there has been a misperception that cardiovascular disease (CVD) mainly affects males. Although lately, there is increasing awareness about the risk of CVD in women, evidence suggests that the management of women with CVD is suboptimal. Purpose The aim of this study is to look at gender differences in treatment and risk factor control after a coronary event across countries with varying income levels. Methods Analyses were based on the ESC-EORP EUROASPIRE V survey, including patient information from 27 European countries. Patients included (18–80 years), were hospitalised for an ischaemic coronary event. Information on medical treatment, risk factors and behavioural changes were obtained during patient interviews (6 months to 2 years after hospitalization). Findings on treatment and risk factor control were compared with the European guidelines on CVD prevention (2016). Country classification by income level (low/medium income vs. high income) was done according to the World Bank Atlas method. Logistic regression analyses adjusted for sex, age, education level, country income, surgical intervention, stroke, heart failure and diabetes were performed. Results Data from 8261 coronary patients, of which 25.8% women, were included in the analyses. Mean (SD) age at the interview was 62.95 (9.72) years for men and 65.36 (9.21) years for women. First, when looking at the evidence based medication intake, no gender differences were seen in the prescription of antiplatelets/aspirin, whereas statins were more often prescribed in men (82.8% vs. 77.7%; p=0.002). A closer look by country income revealed that this difference is entirely due to the higher statin use among men from low/medium income countries (79.6% vs. 72.3%; p=0.004). Second, the risk factor profile differed substantially between genders. Overall, a worse risk factor profile was seen in women. Although, men were more likely to smoke (20.7% vs. 12.8%; p Conclusion These findings suggest a worse risk factor profile in women despite little to no gender differences in medical treatment. Further research is needed to understand the gender-differential in risk factor control. Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): Fonds voor hartchirurgie - Fonds pour la Chirurgie Cardiaque