Gender- and sex-specific research patterns in different cardiovascular diseases: a comparison between myocardial infarction and stroke

Background: Cardiovascular diseases represent the leading cause of mortality and disability worldwide. Variations in gender-/sex-specific research patterns between different cardiovascular endpoints are unclear. We compared frequency, content and funding scheme of published gender/sex-specific cardiovascular research between stroke and myocardial infarction (MI). Methods: Systematic literature search in Pubmed was performed for gender/sex-specific articles in stroke and MI published 1978–2008. A specifically designed text-mining programme including gender-/sex-specific search terms was used. Abstracts were screened for gender-relevance and classified by two independent investigators into epidemiology, pathophysiology, clinical presentation, management, outcomes research, and reviews. For identification of funding sources only abstracts published between 1999 and 2008 were screened and classified into unknown, none, EU, industry, charity/foundation, multiple fundings, national/governmental/research council, universities, others. Results: The initially retrieved 962 articles were limited to 406 (42%); 132 (32%) in stroke and 274 (68%) in MI. Reviews represented 8% of literature in MI and 14% in stroke. Clinical presentation (5% vs. 3% for MI and stroke, respectively) and outcomes research (23% vs. 21%) displayed little difference, while epidemiological (25% vs. 13%) and pathophysiological topics (20% vs. 11%) were more frequently investigated in stroke. Management received little attention (17%) in stroke, while representing the major focus in MI (40%). Gender research in both diseases progressively increased in recent years, although an 8–10 year time lag was present for stroke. Unspecified (42% vs. 32%) and multiple sources (30% vs. 27%) were most common sources of funding for both diseases. National/governmental/research council and charity/foundation funding was higher in stroke (23 vs. 17% and 9% vs. 2%, respectively) denoting slight differences in funding profiles. Conclusions: While gender and sex differences are increasingly considered in MI research, this topic appears to be largely neglected in stroke research, especially in the area of management. Furthermore, slight differences in research schemes emerged.