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September 8, 2026Expert Review of Cardiovascular Therapy

Sex-based differences in acute coronary syndrome: mechanisms, management, and outcomes

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Authors

KBKamil BujakCBCarla BordonaroMMMaria Sara Mauro

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Overview

Clinical review reveals distinct pathophysiological mechanisms, treatment disparities, and adverse outcomes in women with acute coronary syndrome, highlighting the need for sex-specific care.

Key Points

  • Synthesize current evidence on sex-specific biological pathways, diagnostic presentations, therapeutic strategies, and clinical outcomes in patients presenting with acute coronary syndrome.
  • Synthesis of clinical trials, observational registries, and mechanistic investigations evaluating acute coronary syndrome across sexes.
  • Evaluation of biological variables including microvascular dysfunction, plaque morphology, and hormonal differences.
  • Assessment of sex disparities in guideline-directed medical therapy, invasive catheterization timelines, and post-event mortality.
  • Women with acute coronary syndrome present more frequently with non-obstructive coronary artery disease, microvascular dysfunction, and plaque erosion rather than traditional plaque rupture.
  • Female patients experience prolonged symptom-to-door and door-to-balloon times, reduced rates of invasive revascularization, and higher short-term post-infarction mortality.

Cite This Study

Bujak et al. (2026) studied this question.

synapsesocial.com/papers/6aa00a0958e84d0ff5b47cbdhttps://doi.org/10.1080/14779072.2026.2729313
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