Sex differences in the management of atherosclerotic cardiovascular disease

Area of Science:

• Cardiology
• Cardiovascular Disease Research
• Sex-Based Health Differences

Background:

• Persistent disparities exist in the diagnosis, treatment, and prognosis of atherosclerotic cardiovascular disease (ASCVD) between women and men.
• Despite increased focus on sex-based differences, short- and long-term cardiovascular outcomes remain unequal.
• These disparities necessitate investigation into pathophysiologic variations influencing treatment for various acute coronary syndromes (ACS) and myocardial infarction with non-obstructive coronary arteries (MINOCA).

Purpose of the Study:

• To review existing data on differential treatment guidelines, care implementation, and cardiovascular outcomes between women and men.
• To highlight the impact of age as an effect modifier in ACS outcomes for younger women.
• To identify future research directions for improving cardiovascular care in women.

Main Methods:

• Literature review of existing data on sex-based disparities in ASCVD.
• Analysis of treatment patterns and outcomes across different acute coronary syndromes (ACS).
• Consideration of age as a modifying factor in cardiovascular events.

Main Results:

• Young women diagnosed with ACS exhibit higher in-hospital mortality and major adverse cardiovascular events.
• Inadequate representation of women in clinical trials hinders evidence-based therapy implementation.
• Evidence supports the efficacy and safety of cardiovascular medications in women across ACS spectrum.

Conclusions:

• Addressing sex-based disparities in ASCVD is critical for improving cardiovascular care.
• Both patient-centered and system-level interventions are essential for enhancing outcomes.
• Further clinical investigation is needed to close the gap in cardiovascular care for women.