Even “WISE-R?”—an Update on the NHLBI-Sponsored Women’s Ischemia Syndrome Evaluation

Abstract

Purpose of Review-For over 20 years, the Women's Ischemia Syndrome Evaluation (WISE), a program sponsored by the National Heart, Lung, and Blood Institute, has explored diverse and important aspects of ischemic heart disease in women.Recent Findings-Women with symptoms and signs of ischemia but no significant epicardial obstructive coronary artery disease (INOCA) were documented to be at elevated risk for recurrent angina hospitalization, major adverse cardiac events, death, and health resource consumption rivaling those with obstructive coronary disease.Summary-WISE investigators have advanced our understanding of cardiovascular outcomes, systemic manifestations, psychological variables, socioeconomic factors, genetic contributions, hormonal status, advanced imaging, coronary functional findings, biomarkers, patient-reported outcomes, and treatments pertaining to women with this disease entity. This review delves into the ✉

Sex Differences in Coronary Function Test Results in Patient With Angina and Nonobstructive Disease

“…This condition is linked to increased cardiovascular risk, and impaired quality of life, and are a source of it leads to considerable health resource utilization (4)(5)(6). Although ANOCA is thought to be more prevalent in women and the majority of studies are performed in women (6)(7)(8), men are also affected by coronary vasomotor dysfunction (9,10).…”

The Canadian Women’s Heart Health Alliance Atlas on the Epidemiology, Diagnosis, and Management of Cardiovascular Disease in Women — Chapter 6: Sex- and Gender-Specific Diagnosis and Treatment

“… 88 Some cardiac centres have determined that combining entities of cMRI and SPECT allows for improved diagnostic and prognostic value of myocardial perfusion. 95 …”

Latest from the WISE: Contributions to the Understanding of Ischemia and Heart Failure among Women with No Obstructive Coronary Arteries

“…For both INOCA and HFpEF, there is an urgent need for effective therapies [ 15 ], some of which may require tailoring specifically for women vs men [ 16 , 17 ]. As described in our 2020 review [ 18 ], many knowledge gaps and questions remain in understanding at-risk INOCA phenotype, progression to HFpEF, and developing an evidence-base to support diagnostic, prognostic, and management guidelines. Recent WISE studies that fill in some of these research gaps and investigate contributions to ischemia and heart failure in women with no obstructive coronary arteries are summarized here.…”