Why the study?
Despite improved understanding of ischemic heart disease mechanisms in women without obstructive coronary arteries, sex differences in outcomes persist, especially in young women, necessitating female-specific risk stratification for prevention, diagnosis, and treatment.
This review summarizes the contemporary understanding of INOCA and MINOCA in women, emphasizing the need for female-specific diagnostic and management strategies.
Supports sex-specific strategies for INOCA/MINOCA in women; leaves open prospective validation before practice change.
Ischemic heart disease (IHD) is the leading cause of mortality in women. While traditional cardiovascular risk factors play an important role in the development of IHD in women, women may experience sex-specific IHD risk factors and pathophysiology, and thus female-specific risk stratification is needed for IHD prevention, diagnosis, and treatment. Emerging data from the past 2 decades have significantly improved the understanding of IHD in women, including mechanisms of ischemia with no obstructive coronary arteries and myocardial infarction with no obstructive coronary arteries. Despite this progress, sex differences in IHD outcomes persist, particularly in young women. This review highlights the contemporary understanding of coronary arterial function and disease in women with no obstructive coronary arteries, including coronary anatomy and physiology, mechanisms of ischemia with no obstructive coronary arteries and myocardial infarction with no obstructive coronary arteries, noninvasive and invasive diagnostic strategies, and management of IHD.
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A 2022 study studied this question.
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