Why the study?
Although sex-related differences exist in the development, type, and prognosis of chronic coronary syndrome, guidelines do not differentiate approach by sex.
In a large Polish cohort with chronic coronary syndrome, women presented at an older age with a higher burden of classical and non-classical cardiovascular risk factors, had fewer obstructive coronary lesions, were treated conservatively more often, and achieved blood pressure and LDL-C targets less frequently than men.
Sex differences in CCS risk factors and management persist; hypothesis-generating and should not yet alter guideline-directed care.
(1) Background: Coronary artery disease (CAD) remains the leading cause of death in both sexes. The male sex is considered a classical atherosclerosis risk factor, whereas females should be protected by hormonal effects until menopause. Although there are known differences in the development, type, and prognosis of chronic coronary syndrome (CCS) between both sexes, there are no differences in approach in the guidelines. (2) Methods: The sex-related differences in CAD risk factors, treatment, echocardiographic, and angiographic results were assessed among 3291 patients with CCS. (3) Results: Women were older and had a higher prevalence of hypertension, dyslipidaemia, and diabetes mellitus than men. Women were more often treated conservatively than men. There was no difference in the use of beta-blockers and statins among the sexes. The LDL cholesterol goal was less frequently reached by women. Women were treated less often with aspirin than men, but they were treated more often with angiotensin receptor blockers than men. The left ventricle ejection fraction was higher among females. The number of obstructed vessels was higher in men. (4) Conclusions: Women may be more exposed to the risk factors of CAD than men. Men are diagnosed with CAD earlier, and their prevention and therapy are more efficient.
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Muszyński et al. (2023) studied this question.
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