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Residual angina in female patients after coronary revascularization
Birgit Vogel1, Ridhima Goel1, Vijay Kunadian2
1Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Insights
Residual angina after coronary revascularization is common, particularly in women. This review examines sex-based differences in post-procedure angina and explores potential causes, aiming to improve patient quality of life.
Area of Science:
- Cardiology
- Vascular Surgery
- Medical Research
Background:
- Coronary revascularization (percutaneous or surgical) is standard for significant coronary stenosis.
- A primary goal is symptom alleviation and improved quality of life.
- Residual angina post-revascularization is a recognized clinical challenge.
Purpose of the Study:
- To review studies on sex-related differences in residual angina after coronary revascularization.
- To discuss potential underlying mechanisms for observed sex disparities.
- To inform clinical practice and improve outcomes for all patients.
Main Methods:
- Literature review of existing studies on coronary revascularization outcomes.
- Analysis of data regarding post-revascularization angina in relation to patient sex.
- Synthesis of findings to identify trends and potential contributing factors.
Main Results:
- Studies indicate worse outcomes for females post-revascularization (morbidity and mortality).
- Female sex has been identified as a predictor of post-revascularization angina.
- Specific studies focusing on sex differences in residual angina are limited but suggest a disparity.
Conclusions:
- Residual angina affects patient quality of life significantly after coronary revascularization.
- Evidence suggests women may experience more residual angina compared to men.
- Further research into the mechanisms behind sex-based differences is warranted to optimize treatment strategies.
Abstract:
Coronary revascularization, either percutaneous by stent implantation or surgical, has been established as the treatment of choice for patients with significant coronary stenosis. One of the main targets of coronary revascularization - especially in patients with stable disease - is to alleviate symptoms and thereby improve quality of life. Residual angina after successful coronary revascularization is not uncommon and indeed frustrating for the patient as much as for the treating physician. Several studies have shown worse outcomes in females with regard to post-revascularization morbidity and mortality in percutaneous as well as surgical coronary procedures. Although none of the studies has specifically looked at sex-related differences in residual angina after revascularization, some studies have found that female compared to male sex was a predictor of post-revascularization angina. This review article aims to summarize the results of these studies as well as to discuss the potential underlying mechanisms of these findings.
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