Role of Noninvasive Testing in the Clinical Evaluation of Women With Suspected Ischemic Heart Disease

Mieres, Jennifer H.; Gulati, Martha; Merz, Noel Bairey; Berman, Daniel S.; Gerber, Thomas C.; Hayes, Sharonne N.; Kramer, Christopher M.; Min, James K.; Newby, L. Kristin; Nixon, John; Srichai, Monvadi B.; Pellikka, Patricia A.; Redberg, Rita F.; Wenger, Nanette K.; Shaw, Leslee J.

doi:10.1161/cir.0000000000000061

Cited by 220 publications

(226 citation statements)

References 272 publications

(297 reference statements)

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“…34 The higher burden of nonobstructive atherosclerosis in women may result in negative stress tests and obscure the diagnosis of IHD, underscoring the need for additional diagnostic imaging that reveals the nonobstructive pathophysiological mechanisms of IHD. 30,35 Consequently, the 2014 AHA consensus statement for noninvasive evaluation of woman at risk for IHD recommends testing for the full spectrum of IHD ( Figure 3). 35 Contemporary cardiac imaging techniques Many traditional risk factors for ischemic heart disease in women impart a differential risk for women compared with men.…”

Section: 31-33mentioning

confidence: 99%

“…30,35 Consequently, the 2014 AHA consensus statement for noninvasive evaluation of woman at risk for IHD recommends testing for the full spectrum of IHD ( Figure 3). 35 Contemporary cardiac imaging techniques Many traditional risk factors for ischemic heart disease in women impart a differential risk for women compared with men. The role of emerging nontraditional cardiac risks unique to or predominant in women are also being increasingly recognized.…”

Section: 31-33mentioning

confidence: 99%

“…14,35,75,76 The efficacy of aspirin, statins, and β-blockers for secondary prevention are equally established in both men and women and endorsed by guidelines.…”

Section: Less Intense Pharmacotherapymentioning

confidence: 99%

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Sex Differences in Ischemic Heart Disease

Aggarwal

Patel

Mehta

et al. 2018

Circ: Cardiovascular Quality and Outcomes

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240

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Evolving knowledge of sex-specific presentations, improved recognition of conventional and novel risk factors, and expanded understanding of the sex-specific pathophysiology of ischemic heart disease have resulted in improved clinical outcomes in women. Yet, ischemic heart disease continues to be the leading cause of morbidity and mortality in women in the United States. The important publication by the Institute of Medicine titled "Women's Health Research-Progress, Pitfalls, and Promise," highlights the persistent disparities in cardiovascular disease burden among subgroups of women, particularly women who are socially disadvantaged because of race, ethnicity, income level, and educational attainment. These important health disparities reflect underrepresentation of women in research, with the resultant unfavorable impact on diagnosis, prevention, and treatment strategies in women at risk for cardiovascular disease. Causes of disparities are multifactorial and related to differences in risk factor prevalence, access to care, use of evidence-based guidelines, and social and environmental factors. Lack of awareness in both the public and medical community, as well as existing knowledge gap regarding sex-specific differences in presentation, risk factors, pathophysiology, and response to treatment for ischemic heart disease, further contribute to outcome disparities. There is a critical need for implementation of sex-and gender-specific strategies to improve cardiovascular outcomes. This review is tailored to meet the needs of a busy clinician and summarizes the contemporary trends, characterizes current sex-specific outcome disparities, delineates challenges, and proposes transformative solutions for improvement of the full spectrum of ischemic heart disease clinical care and research in women.by guest on May 7, 2018

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Section: 31-33mentioning

confidence: 99%

Section: 31-33mentioning

confidence: 99%

See 1 more Smart Citation

Sex Differences in Ischemic Heart Disease

Aggarwal

Patel

Mehta

et al. 2018

Circ: Cardiovascular Quality and Outcomes

Self Cite

240

View full text Add to dashboard Cite

show abstract

“…2,23 CCTA has a much higher sensitivity and specificity to identify obstructive CAD, as well as ability to identify a nonobstructive disease, making it better suited in women as a first line test.…”

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confidence: 99%

Diagnostic Accuracy of Exercise Electrocardiogram in Women

Shaikh

Budoff

2018

Journal of Women's Health

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“…3 Additional appropriate indications include evaluation of LVEF for comprehensive cardiac structural/perfusion assessment for which the LVEF is only part of the information obtained and is usually not the reason the particular test is chosen. [4][5][6] Current modalities used for this comprehensive evaluation include gated SPECT/ PET, MRI, and CT. 7 As well, for LVEF assessment, radionuclide angiography (RNA) is also frequently employed with transthoracic echocardiography saddling both indications as a primary indication for testing.…”

mentioning

confidence: 99%