Insights from the NHLBI-Sponsored Women's Ischemia Syndrome Evaluation (WISE) Study: Part I: gender differences in traditional and novel risk factors, symptom evaluation, and gender-optimized diagnostic strategies.
Despite a dramatic decline in mortality over the past three decades, coronary heart disease is the leading cause of death and disability in the U.S. Importantly, recent advances in the field of cardiovascular medicine have not led to significant declines in case fatality rates for women when compared to the dramatic declines realized for men. The current review highlights gender-specific issues in ischemic heart disease presentation, evaluation, and outcomes with a special focus on the results published from the National Institutes of Health-National Heart, Lung, and Blood Institute-sponsored Women's Ischemia Syndrome Evaluation (WISE) study. We will present recent evidence on traditional and novel risk markers (e.g., high sensitivity C-reactive protein) as well as gender-specific differences in symptoms and diagnostic approaches. An overview of currently available diagnostic test evidence (including exercise electrocardiography and stress echocardiography and single-photon emission computed tomographic imaging) in symptomatic women will be presented as well as data using innovative imaging techniques such as magnetic resonance subendocardial perfusion, and spectroscopic imaging will also be discussed.
Shaw
Leslee J
LJ
Division of Cardiology, Department of Medicine, Cedars-Sinai Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA. leslee.shaw@cshs.org
Bairey Merz
C Noel
CN
Pepine
Carl J
CJ
Reis
Steven E
SE
Bittner
Vera
V
Kelsey
Sheryl F
SF
Olson
Marian
M
Johnson
B Delia
BD
Mankad
Sunil
S
Sharaf
Barry L
BL
Rogers
William J
WJ
Wessel
Timothy R
TR
Arant
Christopher B
CB
Pohost
Gerald M
GM
Lerman
Amir
A
Quyyumi
Arshed A
AA
Sopko
George
G
D005260:Female; D006334:Heart Function Tests; D006801:Humans; D017202:Myocardial Ischemia / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D012307:Risk Factors; D012737:Sex Factors