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Sex differences in patients presenting with acute coronary syndrome: a state-of-the-art review

Filippo Zilio1, Francesca Musella2, Laura Ceriello3

  • 1Department of Cardiology, Santa Chiara Hospital, APSS, 2, Largo Medaglie d'Oro, Trento 38123, Italy.

Current Problems in Cardiology
|March 1, 2024
PubMed

Insights

Acute coronary syndromes show significant sex differences in causes, symptoms, and treatments. A personalized approach considering female-specific risks and stressors is crucial for effective cardiovascular care.

Area of Science:

  • Cardiology
  • Sex-based Medicine

Background:

  • Acute coronary syndromes (ACS) exhibit notable sex-based disparities in pathophysiology, risk factors, clinical presentation, treatment, and outcomes.
  • Understanding these differences is critical for advancing cardiovascular medicine.

Purpose of the Study:

  • To review the sex differences in ACS, including specific conditions like myocardial infarction with non-obstructed coronary arteries (MINOCA) and spontaneous coronary artery dissection (SCAD).
  • To provide practical guidance for integrating a sex-specific approach into clinical practice.

Main Methods:

  • Comprehensive literature review focusing on sex differences in ACS.
  • Analysis of specific ACS subsets and alternative diagnoses such as Takotsubo cardiomyopathy and myocarditis.

Main Results:

  • Significant variations exist between sexes in ACS pathophysiology, risk profiles, symptom manifestation, and treatment responses.
  • Conditions like MINOCA, SCAD, Takotsubo cardiomyopathy, and myocarditis present unique sex-specific considerations.

Conclusions:

  • Clinical practice should incorporate a sex-specific approach, including assessment of female-specific risk factors, hormonal status, and hormonal therapy.
  • Investigating physical and psychological stressors is essential, particularly for SCAD and Takotsubo cardiomyopathy.

Keywords:
Acute coronary syndromeGender medicineMINOCASpontaneous coronary artery dissectionTakotsubo cardiomyopathy

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