Coronary Artery Disease in Women—Review of Risk Factors and Emerging Concepts.

Autor: Velu, Dhivya, Challa, Abhiram, Hamirani, Yasmin, Atti, Varunsiri, Trinh, Anhthu, Renzelli-Cain, Roberta, Kadiyala, Madhavi
Zdroj: Current Cardiovascular Risk Reports; Feb2024, Vol. 18 Issue 2, p25-44, 20p
Abstrakt: Purpose of Review: Coronary artery disease (CAD) in women is an evolving area of interest in cardiovascular medicine. This review seeks to provide a summary of contemporary insights into the gender-specific pathophysiology of CAD, particularly focusing on emerging risk factors and hormonal biology in women. In addition, we make our observations on gender differences in guideline-based management, highlighting the gaps in care and joining others in expounding the need for further research and gender-specific recommendations in the management of CAD. Recent Findings: Recent publications have brought into focus gender-based differences in the diagnosis and management of CAD with a demonstrable bias that adversely affects women. Since the recognition of such bias, contemporary clinical trials are designed to pay particular attention to equal representation in research studies as well as specifically evaluate gender-based outcomes. It has come to light that INOCA or ischemia with non-obstructive coronaries disproportionately affects women. Additionally, women are prone to more complications with interventions. Investigations are underway to understand the gender discrepancies better to address women's cardiovascular needs. There is a need for further studies to fully understand the unique hormonal biology and life stages of women, which affect coronary physiology. Additionally, socio-psychological factors that have a disproportionate influence on women need further study. Advances in cardiac imaging, particularly in coronary CT angiography and cardiac MRI, have the potential to accurately and non-invasively diagnose cardiovascular pathology so that care for women can be individualized in the era of precision medicine. Summary: Gender-specific care of women with cardiovascular disease starts early in life by recognizing the complex interplay between vascular and neuro-hormonal biology as well as psycho-social, environmental, and cultural factors. In this review, we discuss the less well-recognized risk factors, conditions prevalent in women that affect coronary biology, and the current management gaps in addressing the needs of women with CAD. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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