Insights from the NHLBI-Sponsored Women's Ischemia Syndrome Evaluation (WISE) Study: Part II: gender differences in presentation, diagnosis, and outcome with regard to gender-based pathophysiology of atherosclerosis and macrovascular and microvascular coronary disease.
Coronary heart disease is the leading cause of death and disability in the U.S., but recent advances have not led to declines in case fatality rates for women. The current review highlights gender-specific issues in ischemic heart disease (IHD) presentation, evaluation, and outcomes with a special focus on the results derived from the National Institutes of Health-National Heart, Lung, and Blood Institute-sponsored Women's Ischemia Syndrome Evaluation (WISE) study. In the second part of this review, we will assess new evidence on gender-based differences in vascular wall or metabolic alterations, atherosclerotic plaque deposition, and functional expression on worsening outcomes of women. Additionally, innovative cardiovascular imaging techniques will be discussed. Finally, we identify critical areas of further inquiry needed to advance this new gender-specific IHD understanding into improved outcomes for women.
Bairey Merz
C Noel
CN
Division of Cardiology, Department of Medicine, Cedars-Sinai Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA. Noel.BaireyMerz@cshs.org
Shaw
Leslee J
LJ
Reis
Steven E
SE
Bittner
Vera
V
Kelsey
Sheryl F
SF
Olson
Marian
M
Johnson
B Delia
BD
Pepine
Carl J
CJ
Mankad
Sunil
S
Sharaf
Barry L
BL
Rogers
William J
WJ
Pohost
Gerald M
GM
Lerman
Amir
A
Quyyumi
Arshed A
AA
Sopko
George
G
D050197:Atherosclerosis / Q000503:physiopathology; D003327:Coronary Disease / Q000503:physiopathology; D005260:Female; D006801:Humans; D017202:Myocardial Ischemia / Q000175:diagnosis* / Q000503:physiopathology*; D011379:Prognosis; D018570:Risk Assessment; D012737:Sex Factors