Kris R Kawamoto1,2, Melinda B Davis1,2, Claire S Duvernoy3,4. 1. Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, 48105-2399, USA. 2. Cardiology Section, Medical Service, VA Ann Arbor Healthcare System, 2215 Fuller Rd., Box 111a, Ann Arbor, MI, 48105-2399, USA. 3. Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, 48105-2399, USA. duvernoy@umich.edu. 4. Cardiology Section, Medical Service, VA Ann Arbor Healthcare System, 2215 Fuller Rd., Box 111a, Ann Arbor, MI, 48105-2399, USA. duvernoy@umich.edu.
Abstract
PURPOSE OF REVIEW: Increased awareness of cardiovascular disease in women has prompted studies to investigate gender-related disparities in acute coronary syndromes (ACSs). In this review, we discuss findings from current literature on the clinical presentation, pathophysiology, diagnosis, and management of ACS in women as compared to men. RECENT FINDINGS: Emerging data show that cardiovascular disease (CVD) continues to be the leading cause of death in women and the annual mortality rate from CVD remains higher in women compared to men. Recent studies demonstrate sex-specific differences in patients presenting with ACS. Comorbidities, especially diabetes, are more common in young women compared with age-matched men who develop acute myocardial infarction (AMI). Women are more likely to have atypical symptoms and nonobstructive coronary disease on angiography. Women are less likely to receive guideline-based therapies. They have higher rates of peri-procedural complications with PCI and are less likely to be referred to cardiac rehabilitation. Awareness of differences in the underlying pathophysiology of coronary disease in women compared to men may lead to improved gender-based diagnostic and treatment modalities. However, until more studies are performed, efforts should be directed toward improving delivery of current, gender-neutral guidelines in women just as in men.
PURPOSE OF REVIEW: Increased awareness of cardiovascular disease in women has prompted studies to investigate gender-related disparities in acute coronary syndromes (ACSs). In this review, we discuss findings from current literature on the clinical presentation, pathophysiology, diagnosis, and management of ACS in women as compared to men. RECENT FINDINGS: Emerging data show that cardiovascular disease (CVD) continues to be the leading cause of death in women and the annual mortality rate from CVD remains higher in women compared to men. Recent studies demonstrate sex-specific differences in patients presenting with ACS. Comorbidities, especially diabetes, are more common in young women compared with age-matched men who develop acute myocardial infarction (AMI). Women are more likely to have atypical symptoms and nonobstructive coronary disease on angiography. Women are less likely to receive guideline-based therapies. They have higher rates of peri-procedural complications with PCI and are less likely to be referred to cardiac rehabilitation. Awareness of differences in the underlying pathophysiology of coronary disease in women compared to men may lead to improved gender-based diagnostic and treatment modalities. However, until more studies are performed, efforts should be directed toward improving delivery of current, gender-neutral guidelines in women just as in men.
Authors: Carl J Pepine; Keith C Ferdinand; Leslee J Shaw; Kelly Ann Light-McGroary; Rashmee U Shah; Martha Gulati; Claire Duvernoy; Mary Norine Walsh; C Noel Bairey Merz Journal: J Am Coll Cardiol Date: 2015-10-27 Impact factor: 24.094
Authors: Patrick T O'Gara; Frederick G Kushner; Deborah D Ascheim; Donald E Casey; Mina K Chung; James A de Lemos; Steven M Ettinger; James C Fang; Francis M Fesmire; Barry A Franklin; Christopher B Granger; Harlan M Krumholz; Jane A Linderbaum; David A Morrow; L Kristin Newby; Joseph P Ornato; Narith Ou; Martha J Radford; Jacqueline E Tamis-Holland; Carl L Tommaso; Cynthia M Tracy; Y Joseph Woo; David X Zhao Journal: Catheter Cardiovasc Interv Date: 2013-01-08 Impact factor: 2.692
Authors: Rachel P Dreyer; Kim G Smolderen; Kelly M Strait; John F Beltrame; Judith H Lichtman; Nancy P Lorenze; Gail D'Onofrio; Héctor Bueno; Harlan M Krumholz; John A Spertus Journal: Eur Heart J Acute Cardiovasc Care Date: 2015-02-13
Authors: Lasse Jespersen; Anders Hvelplund; Steen Z Abildstrøm; Frants Pedersen; Søren Galatius; Jan K Madsen; Erik Jørgensen; Henning Kelbæk; Eva Prescott Journal: Eur Heart J Date: 2011-09-11 Impact factor: 29.983
Authors: Jose A Suaya; Donald S Shepard; Sharon-Lise T Normand; Philip A Ades; Jeffrey Prottas; William B Stason Journal: Circulation Date: 2007-09-24 Impact factor: 29.690
Authors: S Dey; M D Flather; G Devlin; D Brieger; E P Gurfinkel; P G Steg; G Fitzgerald; E A Jackson; K A Eagle Journal: Heart Date: 2008-05-07 Impact factor: 5.994
Authors: Peggy Robinet; Dianna M Milewicz; Lisa A Cassis; Nicholas J Leeper; Hong S Lu; Jonathan D Smith Journal: Arterioscler Thromb Vasc Biol Date: 2018-01-04 Impact factor: 8.311
Authors: Ryan T Hubbard; Maria C Arciniegas Calle; Sergio Barros-Gomes; Joyce A Kukuzke; Patricia A Pellikka; Rajiv Gulati; Hector R Villarraga Journal: BMC Cardiovasc Disord Date: 2017-08-24 Impact factor: 2.298