医学
急性冠脉综合征
性别特征
疾病
社会心理的
人口
临床试验
重症监护医学
内科学
心肌梗塞
精神科
环境卫生
作者
Ahmed Haider,Susan Bengs,Judy Luu,Elena Osto,Jolanta M. Siller‐Matula,Taulant Muka,Cathérine Gebhard
标识
DOI:10.1093/eurheartj/ehz898
摘要
Abstract Although health disparities in women presenting with acute coronary syndrome (ACS) have received growing attention in recent years, clinical outcomes from ACS are still worse for women than for men. Women continue to experience higher patient and system delays and receive less aggressive invasive treatment and pharmacotherapies. Gender- and sex-specific variables that contribute to ACS vulnerability remain largely unknown. Notwithstanding the sex differences in baseline coronary anatomy and function, women and men are treated the same based on guidelines that were established from experimental and clinical trial data over-representing the male population. Importantly, younger women have a particularly unfavourable prognosis and a plethora of unanswered questions remains in this younger population. The present review summarizes contemporary evidence for gender and sex differences in vascular biology, clinical presentation, and outcomes of ACS. We further discuss potential mechanisms and non-traditional risk conditions modulating the course of disease in women and men, such as unrecognized psychosocial factors, sex-specific vascular and neural stress responses, and the potential impact of epigenetic modifications.
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