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Sex-Related Outcomes of Medical, Percutaneous, and Surgical Interventions for Coronary Artery Disease: JACC Focus

Mario Gaudino1, Antonino Di Franco1, Davide Cao2

  • 1Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, New York, USA.

Journal of the American College of Cardiology
|April 8, 2022
PubMed

Insights

Women experience worse outcomes for coronary artery disease (CAD) due to biological and sociocultural factors. This review highlights sex-specific differences in CAD treatment outcomes, emphasizing the need for tailored strategies.

Area of Science:

  • Cardiology
  • Sex-based differences in medicine
  • Clinical outcomes research

Background:

  • Coronary artery disease (CAD) affects men and women differently, with women often experiencing poorer outcomes.
  • Biological and sociocultural factors contribute to these sex-based disparities in CAD epidemiology and treatment.
  • Existing clinical studies inadequately represent women, hindering the development of sex-specific management guidelines.

Purpose of the Study:

  • To review current evidence on sex-related differences in coronary artery disease (CAD).
  • To focus on differential outcomes following medical therapy, percutaneous coronary interventions, and coronary artery bypass surgery in men versus women.

Main Methods:

  • Systematic review of existing literature on sex differences in CAD.
  • Analysis of outcomes data from medical therapy, percutaneous coronary interventions, and coronary artery bypass surgery.

Main Results:

  • Women exhibit higher residual platelet reactivity on antiplatelet drugs compared to men.
  • Women face increased adverse cardiovascular outcomes after percutaneous coronary revascularization.
  • Women report higher operative and long-term mortality rates following coronary artery bypass surgery.

Conclusions:

  • Significant sex-based differences exist in CAD outcomes across various treatment modalities.
  • Underrepresentation of women in clinical trials limits understanding and addressing these disparities.
  • Development and implementation of sex-specific management strategies for CAD are crucial.

Keywords:
coronary artery diseasesexwomen

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