Sex differences in coronary artery disease: pathological observations

Area of Science:

• Cardiology
• Sex-based differences in cardiovascular disease

Background:

• Cardiovascular disease (CVD) is a leading cause of death globally.
• Most CVD research historically focused on men, leading to knowledge gaps regarding women's health.
• Risk factors and disease presentation in coronary artery disease (CAD) can differ significantly between sexes.

Purpose of the Study:

• To review and highlight the distinct characteristics of coronary artery disease (CAD) in women.
• To examine sex-specific differences in risk factors and plaque morphology.
• To inform clinical understanding and treatment strategies for female cardiovascular patients.

Main Methods:

• Literature review focusing on studies comparing cardiovascular disease in men and women.
• Analysis of data on risk factor impact, including smoking and menopause.
• Examination of plaque morphology in cases of sudden coronary death and acute myocardial infarction.

Main Results:

• Smoking has a more pronounced negative effect on CAD in women than in men.
• Menopause significantly impacts CAD presentation in women, with plaque erosion common in younger women and plaque rupture in older women.
• Differences in plaque morphology exist between men and women with acute coronary events.

Conclusions:

• Cardiovascular disease (CVD) manifestation and progression differ between men and women.
• Sex-specific risk factors and pathophysiological mechanisms, such as plaque morphology, require further investigation.
• Tailored approaches considering sex differences are essential for managing coronary artery disease (CAD) in women.