Sex and gender in cardiovascular medicine: presentation and outcomes of acute coronary syndrome.

Haider, Ahmed; Bengs, Susan; Luu, Judy; Osto, Elena; Siller-Matula, Jolanta M; Muka, Taulant; Gebhard, Catherine (2020). Sex and gender in cardiovascular medicine: presentation and outcomes of acute coronary syndrome. European Heart Journal, 41(13), pp. 1328-1336. Oxford University Press 10.1093/eurheartj/ehz898

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Although health disparities in women presenting with acute coronary syndrome (ACS) have received growing attention in recent years, clinical outcomes from ACS are still worse for women than for men. Women continue to experience higher patient and system delays and receive less aggressive invasive treatment and pharmacotherapies. Gender- and sex-specific variables that contribute to ACS vulnerability remain largely unknown. Notwithstanding the sex differences in baseline coronary anatomy and function, women and men are treated the same based on guidelines that were established from experimental and clinical trial data over-representing the male population. Importantly, younger women have a particularly unfavourable prognosis and a plethora of unanswered questions remains in this younger population. The present review summarizes contemporary evidence for gender and sex differences in vascular biology, clinical presentation, and outcomes of ACS. We further discuss potential mechanisms and non-traditional risk conditions modulating the course of disease in women and men, such as unrecognized psychosocial factors, sex-specific vascular and neural stress responses, and the potential impact of epigenetic modifications.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM)

UniBE Contributor:

Muka, Taulant

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

0195-668X

Publisher:

Oxford University Press

Funders:

[4] Swiss National Science Foundation

Language:

English

Submitter:

Andrea Flükiger-Flückiger

Date Deposited:

09 Jan 2020 15:19

Last Modified:

15 Apr 2020 19:26

Publisher DOI:

10.1093/eurheartj/ehz898

PubMed ID:

31876924

Uncontrolled Keywords:

Acute coronary syndrome Gender Sex Women

BORIS DOI:

10.7892/boris.137921

URI:

https://boris.unibe.ch/id/eprint/137921

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