Sex and Gender Differences in Cardiovascular Disease: A Review of Spontaneous Coronary Artery Dissection

Area of Science:

• Cardiology
• Cardiovascular Diseases
• Sex and Gender Differences in Medicine

Background:

• Cardiovascular diseases (CVDs) exhibit significant sex and gender disparities.
• Spontaneous coronary artery dissection (SCAD) is an under-recognized cause of acute coronary syndrome, particularly in women.

Purpose of the Study:

• To review current evidence on sex- and gender-specific aspects of SCAD.
• To identify knowledge gaps in the pathophysiology, epidemiology, and clinical management of SCAD.
• To highlight sex-based differences in SCAD presentation, risk factors, diagnosis, and treatment.

Main Methods:

• Comprehensive literature search of existing studies on SCAD and sex/gender differences.
• Synthesis of evidence regarding SCAD pathophysiology, epidemiology, and clinical characteristics.
• Analysis of diagnostic modalities and therapeutic strategies for SCAD.
• Identification of sex- and gender-based disparities in management and counseling.

Main Results:

• SCAD predominantly affects younger women and presents differently than atherosclerotic coronary artery disease.
• Risk factors, triggers, and anatomical patterns of SCAD show sex-specific variations.
• Diagnostic approaches and management strategies require tailored considerations for sex and gender.
• Limited data exists on long-term outcomes and optimal follow-up for SCAD patients.

Conclusions:

• Understanding sex and gender differences is crucial for effective SCAD management.
• Further research is needed to address knowledge gaps in SCAD, particularly concerning sex-specific mechanisms and tailored therapies.
• Clinical practice should incorporate sex- and gender-informed approaches for diagnosis and patient counseling in SCAD.