Percutaneous Coronary Interventions in Women

Area of Science:

• Cardiology
• Vascular Biology
• Sex-Based Medicine

Background:

• Cardiovascular disease (CVD) is a leading global cause of death in women.
• Significant disparities exist in the diagnosis, management, and outcomes of ischemic heart disease (IHD) in women compared to men.
• Understanding sex-based differences is critical for improving cardiovascular health in women.

Purpose of the Study:

• To review factors contributing to sex-based differential outcomes of percutaneous coronary interventions (PCI) in women.
• To highlight unique pathological processes and risk factors in women's cardiovascular disease.
• To emphasize the need for improved representation of women in clinical trials.

Main Methods:

• Literature review of studies examining sex differences in cardiovascular disease.
• Analysis of hormonal influences, atherosclerosis progression, and plaque characteristics in women.
• Examination of outcomes in acute coronary syndromes (ACS) presentations in women.

Main Results:

• Hormonal factors lead to distinct coronary plaque characteristics and unique pathologies (e.g., spontaneous coronary artery dissection, myocardial infarction with non-obstructive coronary arteries) in women.
• Women presenting with ACS are often older, have more comorbidities, and experience higher mortality rates.
• Current clinical trials lack adequate representation of women, leading to knowledge gaps.

Conclusions:

• Awareness of distinct vascular biology and risk factors in women is essential for reducing cardiovascular mortality.
• Individualized treatment approaches are needed, informed by sex-specific research.
• Increased representation of women in clinical trials is crucial for advancing cardiovascular care.