Coronary Arterial Function and Disease in Women With No Obstructive Coronary Arteries

Area of Science:

• Cardiology
• Women's Cardiovascular Health

Background:

• Ischemic heart disease (IHD) is the primary cause of mortality in women globally.
• Traditional cardiovascular risk factors are important, but sex-specific factors and pathophysiology contribute to IHD in women.
• There is a need for female-specific risk stratification for IHD prevention, diagnosis, and treatment.

Purpose of the Study:

• To review the current understanding of coronary arterial function and disease in women.
• To focus on the mechanisms, diagnosis, and management of ischemia with no obstructive coronary arteries (INOCA) and myocardial infarction with no obstructive coronary arteries (MINOCA) in women.
• To highlight persistent sex differences in IHD outcomes, especially in younger women.

Main Methods:

• Review of emerging data from the past two decades on IHD in women.
• Analysis of contemporary understanding of coronary anatomy and physiology in relation to IHD.
• Examination of noninvasive and invasive diagnostic strategies for IHD in women.

Main Results:

• Significant progress has been made in understanding IHD in women, including INOCA and MINOCA.
• Sex differences in IHD outcomes persist, particularly in young women.
• The review synthesizes current knowledge on coronary function, disease mechanisms, diagnostics, and management.

Conclusions:

• Understanding sex-specific aspects of IHD is crucial for improving outcomes in women.
• Further research and tailored approaches are needed for IHD prevention, diagnosis, and treatment in women.
• Contemporary reviews are essential for addressing the complexities of IHD in women, especially concerning INOCA/MINOCA.