Recent Developments in Sex-Related Differences in Presentation, Prognosis, and Management of Coronary Artery Disease

Parvand, Mahraz; Rayner-Hartley, Erin; Sedlak, Tara

doi:10.1016/j.cjca.2018.01.007

Cited by 35 publications

(25 citation statements)

References 101 publications

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“…Al respecto, Saldarriaga y colaboradores detectaron que solo el 63% de las mujeres en su primer evento coronario presentaban este factor de riesgo. (20) Parvand et al (21) en 2018, por medio de una revisión de la literatura, identificaron la menopausia como factor de riesgo de enfermedad coronaria; al igual que Isiadinso y Shaw describen que el riesgo en las mujeres aumenta 10 años después del inicio de la menopausia, la menarca temprana y la menopausia prematura; factores asociados con un mayor riesgo de cardiopatía coronaria. (22) En relaciòn con la percepción del síntoma, 85% reportó el dolor o molestia en cualquier parte del pecho como el síntoma más frecuente; con porcentajes inferiores manifestaron presencia de angustia, palpitaciones y miedo inusual, entre otros.…”

Section: Discussionunclassified

Síndrome coronario agudo en mujeres desde la teoría del manejo del síntoma

2020

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Objetivo: Identificar los factores de riesgo para enfermedad cardiovascular y la experiencia del síntoma del Síndrome Coronario Agudo en las mujeres, según la teoría del Manejo del Síntoma.Método: Estudio observacional de corte transversal, participaron 81 mujeres con SCA atendidas en un Hospital Universitario en Colombia. Se analizaron variables sociodemográficas, factores de riesgo para enfermedad cardiovascular, acciones de respuesta ante los síntomas y la percepción, evaluaciòn y respuesta al síntoma a través de la aplicación del instrumento sobre la Experiencia del Síntoma en la Mujer con SCA.Resultados: De los participantes el 80% superaron los 60 años de edad, en su mayoría con un nivel bajo de escolaridad y residencia urbana. El principal factor de riesgo fue la HTA y más del 50% referían sedentarismo, dislipidemia y dieta malsana. Las mujeres presentaron en promedio 10 síntomas atípicos por cada evento, destacándose el dolor o molestia en el pecho en un 85%. El 66,3 % definieron el origen del síntoma como un problema extracardíaco y 4 de cada 10 pacientes consideró las manifestaciones como insignificantes. El 16% tomó remedios caseros y el 25% esperaron que pasara la sintomatología sin buscar atención profesional. La relación entre el tiempo en asistir a consulta médica e ignorar los síntomas, presentó significancia estadística (p=0,000).Conclusiones: Las mujeres con SCA presentaron diversidad de síntomas, no percibieron la gravedad de sus manifestaciones y, por lo general, respondieron tardíamente ante los síntomas, factor relevante para la atención y tratamiento oportuno. Objective: To identify the risk factors for cardiovascular disease and the experience of the symptom of Acute Coronary Syndrome (ACS) in women, according to the theory of Symptom Management.Method: Observational cross-sectional study, 81 women with ACS attended at a University Hospital in Colombia participated. Sociodemographic variables, risk factors for cardiovascular disease, response actions to symptoms and perception, evaluation and response to symptoms were analyzed through the instrument application on the Experience of the Symptom in Women with ACS.Results: Of participants 80% were over 60 years old, the majority with a low level of education and urban residence. The main risk factor was hypertension and more than 50% of them reported sedentary lifestyle, dyslipidemia, and an unhealthy diet. Women presented an average of 10 atypical symptoms for each event, highlighting chest pain or discomfort in 85%. 66.3% defined the origin of the symptom as an extra-cardiac conditions and 4 out of 10 patients considered the manifestations as insignificant. 16% of the participants took home remedies and 25% of them waited the symptoms to improve without request professional attention. The relationship between time in attending medical consultation and ignoring the symptoms presents statistical significance (p = 0.000).Conclusions: Women with ACS presented a variety of symptoms, do not perceive the severity of its manifestations, and generally respond late to symptoms, a relevant factor for timely care and treatment.

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Section: Discussionunclassified

Síndrome coronario agudo en mujeres desde la teoría del manejo del síntoma

2020

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“…It is well known that women have different pathophysiology, presentation, and outcomes of coronary artery disease compared with men. 24 The specificity of vascular disease manifestations in women is not limited to coronary artery disease: Women present particular features of vascular aneurysm pathophysiology and outcomes, 25 as well as of peripheral vascular disease. 26 Selfmanagement approaches are an interesting and effective technique in the management of cardiac pain in women.…”

Section: Vascular Diseasementioning

confidence: 99%

Sex as a Key Variable in Predicting Cardiovascular Outcomes: Rapidly Evolving Knowledge but Much More Needed

Nattel

Pilote

2020

Canadian Journal of Cardiology

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“…At the risk factor level, diabetes and smoking have a disproportionally large effect on atherosclerosis risk in women compared with men [8]. Other classical risk factors such as hypertension and dyslipidaemia affect the risk equally in both sexes [1].…”

Section: Structural and Functional Alterations In Macrovascular Diseasementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Women suffering from coronary artery disease (CAD), one of the leading causes of death globally, have a worse short-and long-term prognosis than men [1,2]. They also more often present with clean epicardial arteries (non-obstructive CAD) than men [1], suggesting sex differences are present in the underlying aetiology. The Women's Ischemia Syndrome Evaluation study found that women with persistent angina complaints and non-obstructive CAD had twice the risk of cardiovascular events compared with women without complaints [3].…”

Section: Introductionmentioning

confidence: 99%

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Sex-Specific Aspects in the Pathophysiology and Imaging of Coronary Macro- and Microvascular Disease

Groepenhoff

Bots

Kessler

et al. 2019

J. of Cardiovasc. Trans. Res.

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Sex differences in coronary artery disease (CAD) are well established, with women presenting with non-obstructive CAD more often than men do. However, recent evidence has identified coronary microvascular dysfunction as the underlying cause for cardiac complaints, yet sex-specific prevalence numbers are inconclusive. This review summarises known sex-specific aspects in the pathophysiology of both macro-and microvascular dysfunction and identifies currently existing knowledge gaps. In addition, this review describes current diagnostic approaches and whether these should take underlying sex differences into account by, for example, using different techniques or cut-off values for women and men. Future research into both innovation of imaging techniques and perfusion-related sex differences is needed to fill evidence gaps and enable the implementation of the available knowledge in daily clinical practice.

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Recent Developments in Sex-Related Differences in Presentation, Prognosis, and Management of Coronary Artery Disease

Cited by 35 publications

References 101 publications

Síndrome coronario agudo en mujeres desde la teoría del manejo del síntoma

Síndrome coronario agudo en mujeres desde la teoría del manejo del síntoma

Sex as a Key Variable in Predicting Cardiovascular Outcomes: Rapidly Evolving Knowledge but Much More Needed

Sex-Specific Aspects in the Pathophysiology and Imaging of Coronary Macro- and Microvascular Disease

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