Munich, Germany – February 19, 2026 – A pioneering multicentric Italian registry has begun to illuminate the distinctive risk landscape and clinical nuances of acute coronary syndromes (ACS) in women, a patient population historically underrepresented in cardiovascular research yet disproportionately burdened by adverse outcomes. The Gender, Diversity and Inclusion–Acute Coronary Syndromes (GEDI–ACS) registry heralds a novel approach integrating sex-specific, socioeconomic, psychosocial, biochemical, and molecular determinants to foster tailored strategies in diagnosis and management. These preliminary insights were unveiled today at the European Association of Percutaneous Cardiovascular Interventions (EAPCI) Summit 2026 in Munich, establishing a pivotal moment for women’s cardiovascular health.
Ischaemic heart disease remains the predominant cause of mortality worldwide, characterized pathophysiologically by the progressive narrowing of coronary arteries due to atherosclerotic plaque accumulation. Acute coronary syndromes embody the clinical expression of this pathology, manifesting as unstable angina and myocardial infarction (MI), with both ST-segment elevation (STEMI) and non-ST-segment elevation (NSTEMI) presentations. Despite advances in cardiovascular medicine, persistent sex disparities in prevalence, presentation, and outcomes necessitate a focused examination of female patient profiles to mitigate the elevated mortality risk women face relative to men within equivalent demographic cohorts.
Dr. Francesca Napoli, IRCCS San Raffaele Scientific Institute, Milan, emphasized the compelling imperative to amplify research efforts targeting women with ACS. “Women have been consistently underrepresented in clinical trials despite cardiovascular disease constituting a leading cause of death within this group,” she remarked. The GEDI–ACS registry pioneers this integrative perspective, capturing multidimensional data streams that transcend conventional clinical parameters, enabling dissection of intertwining biological, psychosocial, and environmental influences unique to women’s cardiovascular pathology.
The registry is actively enrolling 100 consecutive female patients experiencing ACS—including STEMI, NSTEMI, and unstable angina—across several prominent Italian cardiovascular centers encompassing Northern and Southern regions. These include IRCCS San Raffaele Scientific Institute (Milan), AOU Federico II Naples, Centro Cardiologico Monzino (Milan), and Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico (Milan). This strategic geographical diversity ensures representation across a spectrum of socioeconomic and cultural backgrounds, enriching the dataset’s applicability and translational potential.
Initial data derived from the first 68 enrolled patients reveal an average age of 68 years, with 7.4% identifying as non-Caucasian. Strikingly, 85.3% exhibited low health literacy, underscoring a critical barrier to effective patient education and self-management. Comorbid cardiovascular risk factors were prevalent: 83.6% presented dyslipidaemia, 77.9% had hypertension, and half had a documented history of tobacco use. Moreover, pregnancy-related complications featured prominently, with 32.3% reporting miscarriage and 16.2% premature menopause, variables increasingly recognized for their implications in cardiovascular risk stratification.
Autoimmune diseases, frequently implicated in systemic inflammation and vascular pathology, were present in 32.2% of this cohort, while 16.2% had oncological histories. Psychosocial stressors were notably burdensome; anxiety and depression were reported in 42.6% of patients, highlighting the bidirectional exchange between mental health and cardiac outcomes. Such comprehensive profiling sets the stage for individualized therapeutic frameworks addressing both physical and psychological determinants of disease.
Clinically, ACS represented the first cardiovascular event in 86% of these women, with chest pain documented in 88.2% as the predominant symptom. The distribution of ACS subtypes was relatively balanced with STEMI accounting for 38.2%, NSTEMI 36.8%, and unstable angina 25.0%. Remarkably, 38.2% of patients sustained myocardial infarction with non-obstructive coronary arteries (MINOCA), a complex entity characterized by myocardial ischemia absent the hallmark obstructive lesions. The pathophysiology and optimal treatment paradigms of MINOCA remain elusive, demanding rigorous investigation.
Outcomes within the initial 30-day post-event interval were favorable; no deaths, strokes, or recurrent myocardial infarctions occurred, although recurrent chest pain affected 11.3%. These preliminary results emphasize the potential benefits of early recognition combined with the evolving understanding of risk factors and comorbid conditions tailored specifically to the female ACS population.
Dr. Napoli articulated the translational implications of these findings, noting the interplay between traditional cardiac risk factors and sex-specific elements such as pregnancy history and menopausal status, which may inform primary prevention strategies. “The frequent observation of MINOCA challenges existing therapeutic frameworks, and the high prevalence of anxiety and depression coupled with low health literacy calls for integrated care models that holistically support women during recovery,” she stated.
Professor Alaide Chieffo, the registry’s principal investigator and EAPCI President, affirmed the ongoing commitment to expanding enrollment and follow-up duration, incorporating genetic and molecular analyses to elucidate disease mechanisms further. “Our goal is to fuel precision medicine approaches that recognize the uniqueness of ACS in women, enhancing inclusivity and efficacy of clinical interventions,” she concluded during the summit.
The GEDI–ACS registry symbolizes a transformative paradigm shift in cardiovascular research, pivoting toward equitable gender representation and comprehensive data integration. By addressing psychosocial dimensions, comorbidities, and molecular signatures concurrently, the initiative aspires to optimize prognostication and refine therapeutic avenues for millions of women worldwide afflicted by acute coronary syndromes.
Funded through strategic investments by the European Union’s Next Generation EU initiative, this endeavor exemplifies an international effort to bolster biomedical research infrastructure focused on heterogeneous patient populations. The registry’s collaborative framework enhances the probability of generating robust, generalizable findings vital for guiding future guidelines and policy.
As the cardiovascular community anticipates forthcoming longitudinal data from GEDI–ACS, the study stands as a testament to the indispensable need for sex-conscious investigative rigor. Recognizing and dissecting the multidimensional facets of women’s cardiovascular health will indubitably pave the way for more nuanced, effective, and inclusive cardiac care paradigms in the years to come.
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Subject of Research: Acute coronary syndromes in women, integrating sex-specific, psychosocial, and biological determinants
Article Title: Preliminary findings from the GEDI-ACS registry: integrating sex-specific, psychosocial, and biological determinants in women with acute coronary syndromes
News Publication Date: 19 February 2026
Web References:
https://esc365.escardio.org/EAPCI-Summit/sessions/18129-poster-session-1-acute-coronary-syndromes-1/9012
References:
1. ‘Preliminary findings from the GEDI-ACS registry: integrating sex-specific, psychosocial, and biological determinants in women with acute coronary syndromes’ presented at EAPCI Summit 2026
2. Manfrini O, Tousoulis D, Antoniades C, et al. Sex and gender differences in coronary pathophysiology and ischaemic heart disease. Eur Heart J. 2026 Jan 23:ehaf1059. doi:10.1093/eurheartj/ehaf1059.
Keywords:
Clinical medicine, Health care, Acute coronary syndromes, Women’s cardiovascular health, MINOCA, Sex differences in cardiovascular disease, Psychosocial factors, Health literacy in cardiac patients, Cardiovascular risk stratification, Precision medicine, Molecular cardiology, Multicenter registry
Tags: acute coronary syndromes in womencardiovascular health disparities by sexfemale acute myocardial infarction outcomesGEDI-ACS registry findingsgender differences in heart diseasemolecular markers in acute coronary syndromespsychosocial determinants of heart diseasesex-specific cardiovascular risk factorssocioeconomic impact on cardiovascular healthSTEMI and NSTEMI in womentailored diagnosis for female heart patientsunderrepresentation of women in cardiovascular research
