Difference of Coronary Artery Disease in Women and Men in Recent Trials

Coronary artery disease (CAD) is the leading cause of mortality worldwide, affecting both men and women, yet significant differences exist in how the disease manifests, progresses, and responds to treatment in the two genders. Men tend to develop CAD earlier, with classic symptoms such as chest pain, while women often experience atypical symptoms, including fatigue, shortness of breath, and back pain, which can delay diagnosis. Hormonal factors, particularly estrogen, offers protective effects to women before menopause, but the risk increases dramatically post-menopause. Men are more likely to have traditional risk factors like smoking, hypertension, and high cholesterol, whereas women often have additional risk factors, including pregnancy-related complications, early menopause, and autoimmune diseases. Diagnostic challenges in women are heightened by atypical presentations and higher rates of microvascular dysfunction, leading to frequent underdiagnosis. Treatment responses also differ, with women experiencing higher rates of complications and mortality after interventions such as stenting or bypass surgery. Psychosocial factors, including higher rates of depression and anxiety in women, further complicate outcomes. Understanding these gender-specific differences is crucial for improving prevention, early diagnosis, and tailored treatment approaches to reduce the global burden of CAD in both men and women.