[Pathophysiology of ischemic heart disease in women]

Area of Science:

• Cardiology
• Gender Medicine
• Public Health

Background:

• Ischemic heart disease (IHD) is a leading global cause of mortality for both genders.
• Significant gender-based differences exist in IHD presentation, pathology, and outcomes.
• Women with IHD often present later in life with a greater comorbidity burden.

Purpose of the Study:

• To delineate the gender-specific mechanisms and vulnerabilities associated with ischemic heart disease.
• To compare the clinical presentation and risk factors of IHD in women versus men.
• To identify potential biases in the prevention, diagnosis, and treatment of IHD in women.

Main Methods:

• Review of existing literature on gender differences in IHD.
• Analysis of epidemiological data comparing male and female IHD patients.
• Examination of pathological differences in epicardial arteries and myocardial tissue.

Main Results:

• Women more frequently exhibit non-obstructive coronary arteries, plaque erosion, spontaneous coronary dissection, and microvascular dysfunction.
• IHD in women typically manifests 7-10 years later than in men, with a higher prevalence of comorbidities like renal failure.
• Younger women (<60) with acute coronary syndromes face nearly double the hospital mortality rate compared to age-matched men.

Conclusions:

• Gender-related differences in IHD pathophysiology, including microvascular dysfunction and plaque erosion, contribute to distinct clinical presentations.
• Delayed diagnosis, treatment biases, and unique disease mechanisms contribute to IHD vulnerabilities in women.
• Further research and tailored clinical strategies are crucial for improving IHD outcomes in women.