JACC Focus Seminar: Sex-related Differences in Cardiovascular Disease
JACC Focus Seminar
Sex-Specific Considerations in the Presentation, Diagnosis, and Management of Ischemic Heart Disease: JACC Focus Seminar 2/7

https://doi.org/10.1016/j.jacc.2021.11.065Get rights and content
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Highlights

  • There are differences in the presentation, diagnosis, and management of IHD in men and women.

  • Women more often have nonobstructive coronary disease than men but face higher morbidity and mortality.

  • Initiatives to address sex-based differences in clinical research could improve outcomes for women with IHD.

Abstract

There are sex-related differences in the epidemiology, presentation, diagnostic testing, and management of ischemic heart disease in women compared with men. The adjusted morbidity and mortality are persistently higher, particularly in younger women and Blacks. Women have more angina but less obstructive coronary artery disease, which affects delays in presentation and diagnosis and testing accuracy. The nonbiological factors play a significant role in access to care, ischemic heart disease management, and guideline adherence. Future research focus includes sex-specific outcomes, characterization of the biological differences, and implementation science around quality of clinical care.

Key Words

coronary artery disease
ischemic heart disease
sex differences
women

Abbreviations and Acronyms

CABG
coronary artery bypass graft surgery
CAD
coronary artery disease
CMR
cardiac magnetic resonance
IHD
ischemic heart disease
MI
myocardial infarction
PCI
percutaneous coronary intervention

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Listen to this manuscript's audio summary by Editor-in-Chief Dr Valentin Fuster on JACC.org.

Javed Butler, MD, MPH, MBA, served as Guest Editor-in-Chief for this paper.

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