Among women with signs and symptoms of ischemia undergoing coronary angiography for suspected obstructive CAD, HF hospitalization at 6-year follow-up was predominantly characterized by a preserved ejection fraction and not associated with obstructive CAD.
Purpose of Review
Heart centers for women (HCW) were developed due to the rising cardiovascular morbidity and mortality in women in the United States in the early 1990s. Our review encompasses the epidemiology, risk factors, diagnostic strategies, treatments, and the role of HCW in managing women with ischemic heart disease (IHD).
Recent Findings
HCW use a multidisciplinary team to manage women with IHD. Due to the paucity of randomized controlled trials investigating various manifestations of IHD, some treatments are not evidence-based such as those for coronary microvascular dysfunction and spontaneous coronary artery dissection. Sex-specific risk factors have been identified and multimodality cardiac imaging is improving in diagnosing IHD in women. Treatments are being studied to help improve symptoms and outcomes in women with IHD.
Summary
There has been progress in the care of women with IHD. HCW can be instrumental in treating women with IHD, doing research, and being a source of research study participants.
Statins are among the most widely prescribed drugs in the western world and play a significant role in reducing cardiovascular risk. However, concern regarding their hepatic safety profile has meant that patients with concurrent liver pathology are often denied such benefits. In this review we consider the evidence for and against the prescription of statins to patients with nonalcoholic fatty liver disease, a group typically associated with high cardiovascular risk. Contrary to current opinion, we find that there is considerable evidence for and little evidence against the prescription of statins to this population and suggest that the guidelines advising against their use in these patients should be reviewed.
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