European Society of Cardiology thinks preventing strokes in women is too complicated

[NoBinturongsHereMate]

Atrial fibrillation causes a greater increase in stroke.risk in women than it does in men, so the scoring tool to assess risk adds a point for female sex.

Or it did.

The ESC has removed that question because: "the inclusion of gender [sic] complicates clinical practice both for healthcare professionals and patients" and "it also omits individuals who identify as non-binary, transgender, or are undergoing sex hormone therapy".

https://x.com/AudreySuffolk/status/1831279559930433813?

(sorry derail strand of thread)

re. ageist sexist comments - I certainly remember when younger hospital consultants were still treated as highly superior beings. And particularly male consultants. I remember one being so rude to me that after he left one of his worshipping trainees came back and she whispered was I alright.

I later attended some sort of patient feedback session. Not a big turn out. Most of the patients said nothing. So I went through my prepared comment and the platform just said thank you.

But what was worse was when the meeting finished the other patients stopped me in the hall to congratulate me, but didn't seem to realise by not even saying I agree or something I could be written of as an hysterical women.

I thought the era of consultants being a law under themselves had died out. But maybe some still have a god complex and aren't challenged..

Yes they were adding a point for being a woman. I saw a cardiologist 2 months ago after being diagnosed with Atrial Fibrillation. I had one point purely for being a woman (age 50).

I guess what I want to understand is why they did it then and can abandon it now?

I'm afraid I've not attempted to read the paper yet, but my DH has AF and my understanding of the score is that it's an overall stroke risk analysis - so factors such as diabetes come in as well as age. That's what matters from the point of view of treatments such as should this person be on anticoagulants, not just the additional stroke risk due to AF.

The experts comment in the Twitter link doesn't say 'Atrial fibrillation causes a greater increase in stroke.risk in women than it does in men' , it says that women with AF face a higher stroke risk than men - these aren't the same thing, the latter sounds like the total stroke risk.

Yes, that's the nub of it.
Is it possible they're dropping female=1 point because data, but putting out press statements saying mumble..gender identity..bumble for, well, woke points?

I absolutely agree with them that including the made up concept of "gender" in their clinical assessment tool is unhelpful. SO DON'T INCLUDE IT, just like you wouldn't include religion. What is this so difficult?

I wonder if ESC opted for this because countries (like Germany) are making it illegal, iirc, to identify the sex of a trans identified person?
However, there have been national studies and systematic reviews that provide new data. There also seem to have been differences between the use of scoring systems. It may be that ESC looks to resolve these by opting to standardise on a scoring system that doesn't use contested categories because it's more straightforward to deliver this scoring system and set of guidelines and then adopt them to local (i.e., national) pragmatic service delivery that reflects the available therapies.

As a woman with AF I can tell you that I was treated with care and attention. My Chad score included age at diagnosis and sex as mentioned, well at that time it did!

They were on to it straight away, every test under the sun, cardioversion, the lot. The problem with me though, was that I was approaching 65 and could not take anticoagulants due to bleeding risk from another issue. So they watched and waited. When it came to my 64th birthday I was put on a list for a Watchman device, which is designed to stop clots (stroke) in those who cannot take blood thinners. I was duly treated and had the device the day before my 65th birthday!. The cardiologist/electrophysiologist was determined that I would have this protection at age 65, so maybe he hadn't read the memo about age 75!

Anyway, just saying that the thought of a stroke initially terrified me, as my mother had Afib and it was undiagnosed, she had three devastating strokes one after the other and suffered greatly, she had her strokes at age 63, so naturally I was concerned.

I cannot believe that report, but I am not surprised. I hope those women with Afib are treated according to risk going forward.

because countries (like Germany) are making it illegal, iirc, to identify the sex of a trans identified person?

Say what now? 😡

I do very genuinely wonder how the intersection of disability rights & trans rights will play out in Germany - well, disabled people will get the shitty end of the stick, but will it be enough to effect change? People are absolutely going to start referencing the Nazis & Aktion T4 - with a sight more accuracy than all the Trans Holocaust nonsense^ - if the German state starts arresting blind people/people with severe learning disabilities/post-ictal epileptics/people with TBIs/people with dementia (etc etc) for correctly sexing people 🤦‍♀️

^ the Nazis had no coherent policy towards trans people, let alone a plan to exterminate them

Two German Podcasters, Kiarash Hossainpour and Philip Hopf, to face jail term with €250,000 for calling a transwoman a man.

I've no idea how they phrased it. Earlier reports of the law (ratified earlier this year) said that the misgendering would need to be intentional. However, I'm so accustomed to mission creep that I'm apprehensive about healthcare workers who would become wary of asking about sex in case it's interpreted as a hostile act of misgendering.

A rant on Reddit from a male who identifies as a woman complaining that a 999 call handler asked for his sex (described at 'gender assigned at birth') when discussing symptoms.

https://www.mumsnet.com/talk/womens_rights/5158576-sex-differences-in-asthma

But with cha2ds2-vasc you give OAC if greater than 2 for male or 3 for female according to ESC guidelines. Having the female category then makes it a bit pointless. Just remove it and make it above 2 for everyone? Acronym isn't as pretty but surely it's simpler for clinicians?