Women with coronary artery disease experience delays in diagnosis, receive less aggressive treatments, and have worse outcomes following medical, percutaneous, and surgical interventions compared to men.
Does sex affect the outcomes of medical, percutaneous, and surgical interventions in patients with coronary artery disease?
This review highlights significant sex-based disparities in the presentation, management, and outcomes of coronary artery disease, emphasizing the need for better representation of women in clinical studies and sex-specific guideline recommendations.
Biological and socio-cultural differences between men and women are complex and likely account for most of the variations in the epidemiology and treatment outcomes of coronary artery disease (CAD) between the two sexes. Women are more likely to present with atypical symptoms and less likely to be referred for invasive testing. They often experience delays in diagnosis and receive less aggressive treatments compared to men. Worse outcomes in women have been described following both conservative and invasive treatments of CAD. Despite the growing recognition of sex-specific determinants of outcomes, representation of women in clinical studies remains low, and sex-specific management strategies are generally not provided in guidelines. In this review, we summarize the current evidence on sex-related differences in patients with CAD, focusing on the differential outcomes following medical therapy, percutaneous coronary interventions, and coronary artery bypass surgery.
“If you are a man, and you need coronary revascularisation, you will receive what we call evidence-based treatment, because there is strong evidence to guide your treatment decision. If you are a woman, that's not the case. We don't have data, and so we use the data generated in men. However, we all know that women are not small men.”
Gaudino et al. (Fri,) conducted a review in Coronary Artery Disease. Female sex vs. Male sex was evaluated. Women with coronary artery disease experience delays in diagnosis, receive less aggressive treatments, and have worse outcomes following medical, percutaneous, and surgical interventions compared to men.