Interventional Management of ACS in Women: STEMI and NSTEMI
Nitish Naik1, Ambuj Roy1, Annapoorna S Kini2
1Department of Cardiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India.
Insights
Women with acute coronary syndromes face poorer outcomes after percutaneous intervention, often due to risk factors like age and comorbidities, not just biological differences. Further research is needed to improve treatment strategies for these women.
Area of Science:
- Cardiology
- Interventional Cardiology
- Women's Cardiovascular Health
Background:
- Acute coronary syndromes (ACS) and ST-elevation myocardial infarction (STEMI) significantly impact women's cardiovascular health, contributing to morbidity and mortality.
- Emerging evidence indicates that poorer outcomes in women undergoing percutaneous intervention (PCI) may be linked to risk factors rather than solely to vascular biology or anatomical challenges.
Purpose of the Study:
- To analyze the factors contributing to suboptimal outcomes in women undergoing PCI for ACS.
- To highlight the underrepresentation of females in clinical trials related to cardiovascular interventions.
- To advocate for targeted strategies addressing risk factors and improving clinical outcomes for women in the catheterization laboratory.
Main Methods:
- Review of current literature and emerging data on sex-based differences in cardiovascular outcomes.
- Analysis of factors influencing outcomes in women undergoing percutaneous coronary intervention.
- Assessment of clinical trial representation for female cardiovascular patients.
Main Results:
- Poorer outcomes in women post-PCI are increasingly attributed to age and comorbidities, rather than inherent biological or anatomical differences.
- Females remain significantly underrepresented in pivotal clinical trials for cardiovascular interventions.
- Existing treatment paradigms may not adequately address the specific risk-factor burden in women.
Conclusions:
- Risk factor management, including age and comorbidities, is crucial for improving PCI outcomes in women.
- Increased female participation in clinical trials is essential for developing sex-specific, evidence-based treatment guidelines.
- Further research is imperative to optimize care for women presenting with acute coronary syndromes to the catheterization laboratory.
Abstract:
Acute coronary syndromes and ST elevation myocardial infarction are a major cause of cardiovascular morbidity and mortality in women. However, emerging data now suggest that the poorer outcomes of women undergoing percutaneous intervention may have less to do with differing vascular biology between males and females or the technical challenges of their coronary anatomy, but more with risk factors, such as age and comorbidities. Nevertheless, females have clearly been underrepresented in clinical trials, and further efforts are now required to properly define effective ways to tackle the risk-factor burden and clinical outcomes in women presenting to the catheterization laboratory.
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