Does gender influence the outcome of ischemic heart disease?

Abstract

Diseases of the cardiovascular system (myocardial infarction, stroke, heart failure, hypertensive heart disease, cardiomyopathy) account for 40% of all deaths in men and up to 49% of all deaths in women. For a long time it was thought that the clinical picture of ischemic heart disease in men and women was similar. Now, however, there are more reports suggesting that diverse manifestations of the symptoms of ischemic disease may be related to differences between sexes. The disparity between women and men is also evident in the diagnostic process, and various pathological mechanisms of cardiovascular diseases, in particular myocardial ischemia in men and women, affect the differences in the results of diagnostic tests. Vasomotor dysfunction is particularly frequent in women, as their coronary vessels are more sensitive to the catecholamines released during mental stress, resulting in spasm and ischemic myocardium. Moreover, a much lower dose of acetylcholine induced vasoconstriction, which indicates that women are more sensitive to this neurotransmitter. Therefore, coronary vasomotor disorders in the form of epicardial and microvascular dysfunction are more often seen in women. All these mentioned factors resulted in higher mortality and poorer quality of life of women suffering from ischemic heart disease.

Patterns and determinants of treatment for coronary artery disease

“…PCI: percutaneous coronary intervention, CABG: coronary artery bypass grafting, NSTEMI: non-ST-elevation myocardial infarction, STEMI: ST-elevation myocardial infarction, LM: left main lesion, RCA: right coronary arteries, LAD: left anterior descending artery, LCX: left circumflex artery, MVD: coronary microvascular disease, *statistically significance value deaths in men and women, respectively. 13 This gender difference in the burden of CAD can be attributed to some variations in risk profile, pathophysiological mechanisms, and diagnosis of CAD between men and women. 14 Indeed, atypical presentation of the CAD, which is mainly due to microvascular angina and more common in women, is associated with poorer outcomes.…”

“…14 Indeed, atypical presentation of the CAD, which is mainly due to microvascular angina and more common in women, is associated with poorer outcomes. 13 Hence this form of CAD warrants special medical care in affected women. 13 Clinical manifestation of CAD varies with the culprit vessel.…”

Gender-Related Differences and Mortality Predictors among Egyptian Hemodialysis Patients: A Multi-Center Prospective Observational Study

“…The presence of IHD as the only predictor of mortality among the females' rather in the males' group, raises the thinking that this co-morbidity could behave differently among both genders. Tomaszewski and his colleagues have reported that IHD carries a poorer quality of life and adverse outcomes in females than males owing to different biological and pathological factors [54]. However, this observation is not settled yet in the hemodialysis population.…”

Karakteristik Pasien Gagal Jantung Akut di RSUP Prof Dr. R. D. Kandou Periode Januari-Desember 2018

“…Situasi ini membuat perempuan yang menderita penyakit jantung koroner lebih lambat menunjukkan efeknya, yaitu sekitar 10 tahun lebih lambat dari pada laki-laki. 7 Pada distribusi jumlah pasien berdasarkan kelompok usia didapatkan 49 pasien berusia >60 tahun (55%), diikuti 20 pasien berusia 50-59 tahun (22,5%), dan 17 pasien berusia 40-49 tahun (19,1%). Pablo dan Fernando 8 menyatakan bahwa pasien gagal jantung akut paling umum untuk perawatan di rumah sakit berusia >60 Tahun.…”