Coronary artery disease in post-menopausal women: are there appropriate means of assessment?

Area of Science:

• Cardiology
• Medical Imaging
• Biomarkers

Background:

• Cardiovascular disease (CVD) recognition highlights sex differences, especially in post-menopausal women with coronary artery disease (CAD).
• Current CAD treatment algorithms, primarily based on male studies, inadequately address microvascular disease prevalent in women.
• Assessing management efficacy for female CAD patients presents unique challenges due to these differences.

Purpose of the Study:

• To review sex differences in CAD, focusing on post-menopausal women.
• To highlight emerging diagnostic and prognostic tools for female CAD patients.
• To emphasize the need for sex-specific cardiovascular imaging and biomarkers in clinical practice.

Main Methods:

• Review of current literature on sex differences in CAD.
• Discussion of advanced imaging modalities like stress perfusion cardiac magnetic resonance imaging and positron emission tomography.
• Exploration of novel biomarkers, including heat shock protein 27, and screening tools such as retinal vasculature imaging.

Main Results:

• Established CAD treatment strategies are often insufficient for women due to differing disease manifestations (e.g., microvascular disease).
• Advanced imaging techniques offer improved diagnostic accuracy and prognostication for women with microvascular CAD.
• Emerging biomarkers and screening tools show promise for future clinical application.

Conclusions:

• Robust, sex-specific cardiovascular imaging modalities and biomarkers are crucial for managing CAD in post-menopausal women.
• Development and integration of these tools into practice guidelines are vital for effective CAD management and treatment efficacy assessment in women.
• Addressing sex-specific aspects of CAD is essential for advancing cardiovascular care for women.