Sex Differences and Emerging New Risk Factors for Atherosclerosis and Its Thrombotic Complications

Area of Science:

• Cardiovascular Medicine
• Sex Differences in Disease
• Atherosclerosis Research

Background:

• Cardiovascular diseases (CVD) are a leading cause of death globally, with distinct prognoses and outcomes between sexes.
• While conventional risk factors are known, non-traditional factors are crucial for understanding residual CVD risk.
• Sex-specific differences in CVD pathophysiology, presentation, prevalence, and outcomes are increasingly recognized.

Purpose of the Study:

• To review current knowledge on sex differences in atherosclerotic plaque composition and clinical evolution.
• To analyze the role of non-traditional risk factors in sex-specific atherosclerosis.
• To discuss the impact of female-specific disorders on CVD.

Main Methods:

• Literature review summarizing current research on sex differences in CVD.
• Analysis of non-traditional risk factors including inflammation, lipoprotein(a), hemostasis, intraplaque calcification, and depression.
• Exploration of sex-differential impacts of chronic infections, gut microbiome, and epigenetics.

Main Results:

• Sex-specificities in non-traditional risk factors significantly influence atherosclerosis development and clinical manifestations.
• Factors like inflammation, lipoprotein(a), hemostasis, intraplaque calcification, and depression exhibit sex-differential effects on CVD.
• Chronic infections, gut microbiome, and epigenetic regulation show potential sex-differential impacts on atherosclerosis.

Conclusions:

• Understanding sex differences in non-traditional risk factors is essential for personalized CVD prevention and treatment.
• Further research is needed to elucidate the mechanisms behind sex-specific atherosclerosis and CVD.
• Addressing female-specific disorders is critical for improving CVD outcomes in women.