Atrial Fibrillation Clinical Trials Suffer From Gender Disparities

Gender disparities persist in clinical trials related to atrial fibrillation (AF) management , according to a study presented at ACC.25.

“Atrial fibrillation (AF) is associated with significant morbidity and mortality. Little is known regarding representation of women in AF-related clinical trials. Our systematic review sought to evaluate the representation of women in AF-related clinical trials,” the researchers noted.

In this systematic review study, researchers queried PubMed, Scopus, and EMBASE databases until January 2024, with a focus on AF-related lifestyle interventions, pharmacologic treatments, catheter ablation, or device therapies for AF. Study data focused on trial characteristics and funding sources.

The primary end point of interest was defined as the overall prevalence of female enrollees determined by means of participation-to-prevalence ratios (PPRs) and stratification by funding sources, type of interventions, and region of enrollment, the researchers noted.

Overall, the analysis consisted of 103 trials involving 218,322 participants. The results showed that there was an average PPR of 1.03, with 43% of trials demonstrating female under-representation (PPR <0.8). The findings showed that university-funded trials (mean PPR, 0.951) demonstrated higher female enrollment compared with industry- and government-funded trials (mean PPR, 0.800).

“Despite advancements in AF management, gender disparities persist in AF related clinical trials, particularly in industry/government-funded studies compared to university-funded trials,” the researchers concluded.

Ibrahim R et al. Representation of women in atrial fibrillation clinical trials: a systematic review. Presented at: ACC25; March 29-31, 2025; Chicago, IL.