Sex, Racial, and Ethnic Disparities in Acute Coronary Syndrome: Novel Risk Factors and Recommendations for Earlier
Haitham Khraishah1, Ralph Daher2, Mahdi Garelnabi3
1Division of Cardiovascular Medicine, University of Maryland School of Medicine, Baltimore (H.K.).
Insights
This review examines global disparities in acute coronary syndromes (ACS) based on sex, race, and ethnicity. Understanding these differences is crucial for improving ACS care and clinical outcomes worldwide.
Area of Science:
- Cardiology
- Public Health
- Health Disparities
Background:
- Acute coronary syndromes (ACS) affect diverse populations globally, with variations in presentation and outcomes.
- Existing research highlights significant disparities in ACS care linked to demographic, geographic, racial, and ethnic factors.
- Underlying pathophysiological differences, including inflammatory and pregnancy-related factors, contribute to these disparities.
Purpose of the Study:
- To summarize global sex, racial, and ethnic differences in acute coronary syndromes (ACS).
- To discuss the relationship between disparities in ACS presentation and management and their impact on clinical outcomes.
- To review the influence of demographic, geographic, racial, and ethnic factors on ACS care.
Main Methods:
- Systematic review of existing literature on sex, racial, and ethnic variations in ACS.
- Analysis of data on presentation, management, and clinical outcomes of ACS across different demographic groups.
- Discussion of risk factors, pathophysiology, and diagnostic methods related to ACS disparities.
Main Results:
- Significant global disparities exist in the incidence, presentation, and management of ACS across sex, racial, and ethnic lines.
- These disparities are associated with differential clinical outcomes, often worse for underrepresented groups.
- Demographic, geographic, and racial/ethnic factors significantly influence the quality and accessibility of ACS care.
Conclusions:
- Addressing sex, racial, and ethnic disparities in ACS is critical for improving global cardiovascular health.
- Early detection of subclinical atherosclerosis using methods like breast arterial calcification and coronary calcium scoring may help mitigate disparities.
- Further research is needed to elucidate the complex interplay of factors contributing to ACS disparities and to develop targeted interventions.
Abstract:
In this review, sex, racial, and ethnic differences in acute coronary syndromes on a global scale are summarized. The relationship between disparities in presentation and management of acute coronary syndromes and effect on worse clinical outcomes in acute coronary syndromes are discussed. The effect of demographic, geographic, racial, and ethnic factors on acute coronary syndrome care disparities are reviewed. Differences in risk factors including systemic inflammatory disorders and pregnancy-related factors and the pathophysiology underlying them are discussed. Finally, breast arterial calcification and coronary calcium scoring are discussed as methods to detect subclinical atherosclerosis and start early treatment in an attempt to prevent clinical disease.
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