Presentation, management, and outcomes of ischaemic heart disease in women

Viola Vaccarino, Lina Badimon, Roberto Corti, Cor De Wit, Maria Dorobantu, Olivia Manfrini, Akos Koller, Axel Pries, Edina Cenko, Raffaele Bugiardini*

*Corresponding author for this work
82 Citations (Scopus)

Abstract

Scientific interest in ischaemic heart disease (IHD) in women has grown considerably over the past 2 decades. A substantial amount of the literature on this subject is centred on sex differences in clinical aspects of IHD. Many reports have documented sex-related differences in presentation, risk profiles, and outcomes among patients with IHD, particularly acute myocardial infarction. Such differences have often been attributed to inequalities between men and women in the referral and treatment of IHD, but data are insufficient to support this assessment. The determinants of sex differences in presentation are unclear, and few clues are available as to why young, premenopausal women paradoxically have a greater incidence of adverse outcomes after acute myocardial infarction than men, despite having less-severe coronary artery disease. Although differential treatment on the basis of patient sex continues to be described, the extent to which such inequalities persist and whether they reflect true disparity is unclear. Additionally, much uncertainty surrounds possible sex-related differences in response to cardiovascular therapies, partly because of a persistent lack of female-specific data from cardiovascular clinical trials. In this Review, we assess the evidence for sex-related differences in the clinical presentation, treatment, and outcome of IHD, and identify gaps in the literature that need to be addressed in future research efforts.

Original languageEnglish
JournalNature Reviews Cardiology
Volume10
Issue number9
Pages (from-to)508-518
Number of pages11
ISSN1759-5002
DOIs
Publication statusPublished - 09.2013

Research Areas and Centers

  • Academic Focus: Center for Brain, Behavior and Metabolism (CBBM)

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