Acute Coronary Syndromes: Differences in Men and Women.
OBJECTIVE
Increased awareness of cardiovascular disease in women has prompted studies to investigate gender-related disparities in acute coronary syndromes (ACSs). In this review, we discuss findings from current literature on the clinical presentation, pathophysiology, diagnosis, and management of ACS in women as compared to men.


RESULTS
Emerging data show that cardiovascular disease (CVD) continues to be the leading cause of death in women and the annual mortality rate from CVD remains higher in women compared to men. Recent studies demonstrate sex-specific differences in patients presenting with ACS. Comorbidities, especially diabetes, are more common in young women compared with age-matched men who develop acute myocardial infarction (AMI). Women are more likely to have atypical symptoms and nonobstructive coronary disease on angiography. Women are less likely to receive guideline-based therapies. They have higher rates of peri-procedural complications with PCI and are less likely to be referred to cardiac rehabilitation. Awareness of differences in the underlying pathophysiology of coronary disease in women compared to men may lead to improved gender-based diagnostic and treatment modalities. However, until more studies are performed, efforts should be directed toward improving delivery of current, gender-neutral guidelines in women just as in men.
Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, 48105-2399, USA.|Cardiology Section, Medical Service, VA Ann Arbor Healthcare System, 2215 Fuller Rd., Box 111a, Ann Arbor, MI, 48105-2399, USA.
Kris R
KR
Kawamoto
Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, 48105-2399, USA.|Cardiology Section, Medical Service, VA Ann Arbor Healthcare System, 2215 Fuller Rd., Box 111a, Ann Arbor, MI, 48105-2399, USA.
Melinda B
MB
Davis
Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, 48105-2399, USA. duvernoy@umich.edu.|Cardiology Section, Medical Service, VA Ann Arbor Healthcare System, 2215 Fuller Rd., Box 111a, Ann Arbor, MI, 48105-2399, USA. duvernoy@umich.edu.
Claire S
CS
Duvernoy
D054058:Acute Coronary Syndrome / Q000150:complications / Q000453:epidemiology*; D015897:Comorbidity; D048909:Diabetes Complications; D003920:Diabetes Mellitus; D005260:Female; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000209:etiology; D012727:Sex Characteristics
Acute coronary syndrome; Gender differences; Myocardial infarction; Nonobstructive coronary disease; Women