Sex-Based Considerations in the Evaluation of Chest Pain and Management of Obstructive Coronary Artery Disease

Madan, Nidhi; Gajo, Eileen; Sanghani, Rupa; Volgman, Annabelle Santos

doi:10.1007/s11883-020-00855-7

Cited by 7 publications

(8 citation statements)

References 107 publications

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“…Daneben warten Frauen länger, bevor sie medizinische Hilfe suchen, was zu der Behandlungsverzögerung beiträgt. Die Behandlung von Frauen ist weniger aggressiv als bei Männern, d. h. es werden weniger Untersuchungen, Aufnahmen auf Intensivstation und Koronarinterventionen durchgeführt [4]. Frauen, die mit einem akuten Koronarsyndrom aufgenommen werden, sind im Mittel 10 Jahre älter als Männer und haben deswegen mehr Begleiterkrankungen und kardiovaskuläre Risikofaktoren [5].…”

Section: Geschlechtsspezifische Unterschiede Der Risikofaktoren Und Symptomeunclassified

“…Obwohl die aortokoronare Bypassoperation der Goldstandard der Behandlung der Hauptstammstenose ist, stellt die PCI eine Option für Patienten mit niedrigem SYNTAX-Score dar. In den randomisierten Studien zeigten Frauen allerdings eine erhöhte Rate kardiovaskulärer Ereignisse und periinterventioneller Infarkte [4].…”

Section: Im Akuten Myokardinfarkt Ist Die Krankenhausletalität Beiunclassified

“…Bei der Diagnostik der KHK wird bei Frauen seltener ein Belastungs-EKG oder eine Koronarangiografie durchgeführt, bei der Therapie seltener eine PCI oder aortokoronare Bypassoperation. Weiterhin werden Rehabilitationsprogramme bei Frauen weniger als bei Männern durchgeführt [4]. Bei der medikamentösen Therapie des chronischen Koronarsyndroms wurden keine geschlechterspezifischen Unterschiede beschrieben.…”

Section: Chronisches Koronarsyndromunclassified

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Geschlechtsspezifische Unterschiede bei koronarer Herzerkrankung

Ott

2022

Aktuelle Kardiologie

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ZusammenfassungDie koronare Herzerkrankung ist die häufigste Herzerkrankung bei Frauen und Männern. Geschlechtsspezifische Unterschiede in der Symptomatik, der Prognose und der Behandlung bei Patienten mit koronarer Herzerkrankung wurden bereits in zahlreichen Studien untersucht. Frauen sind älter, besitzen mehr Komorbiditäten, beklagen eher atypische Symptome, suchen später ärztliche Hilfe auf und werden weniger leitliniengerecht behandelt. In dem Artikel sollen geschlechtsspezifische Unterschiede bei Patienten mit akutem und chronischem Koronarsyndrom zusammengefasst werden.

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Section: Geschlechtsspezifische Unterschiede Der Risikofaktoren Und Symptomeunclassified

Section: Im Akuten Myokardinfarkt Ist Die Krankenhausletalität Beiunclassified

Section: Chronisches Koronarsyndromunclassified

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Geschlechtsspezifische Unterschiede bei koronarer Herzerkrankung

Ott

2022

Aktuelle Kardiologie

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“…Men tend to have a higher risk of plaque ( Ota et al, 2010 ; Merz and Cheng, 2016 ). Interestingly, women with coronary artery disease were less likely to undergo optimal secondary prevention with antiplatelet and lipid-lowering therapies than their male counterparts ( Madan et al, 2020 ).…”

Section: Sex Differences In Cardiovascular Agingmentioning

confidence: 99%

Sex Differences in Molecular Mechanisms of Cardiovascular Aging

Justina

Miguez²,

Priviero

et al. 2021

Front. Aging

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Cardiovascular disease (CVD) is still the leading cause of illness and death in the Western world. Cardiovascular aging is a progressive modification occurring in cardiac and vascular morphology and physiology where increased endothelial dysfunction and arterial stiffness are observed, generally accompanied by increased systolic blood pressure and augmented pulse pressure. The effects of biological sex on cardiovascular pathophysiology have long been known. The incidence of hypertension is higher in men, and it increases in postmenopausal women. Premenopausal women are protected from CVD compared with age-matched men and this protective effect is lost with menopause, suggesting that sex-hormones influence blood pressure regulation. In parallel, the heart progressively remodels over the course of life and the pattern of cardiac remodeling also differs between the sexes. Lower autonomic tone, reduced baroreceptor response, and greater vascular function are observed in premenopausal women than men of similar age. However, postmenopausal women have stiffer arteries than their male counterparts. The biological mechanisms responsible for sex-related differences observed in cardiovascular aging are being unraveled over the last several decades. This review focuses on molecular mechanisms underlying the sex-differences of CVD in aging.

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“…The sex difference in cardiovascular risk has been well-known since the Framingham Study [9][10][11][12]; men have relatively higher risk than women do, so reproductive-aged women are protected from these diseases. The most common cause of cardiovascular morbidity and mortality is coronary artery diseases (CADs) in both sexes, although the clinical appearance of the illnesses may differ [13]. In several acute CADs, such as myocardial infarction, angina pectoris, and sudden cardiac death, pro-thrombogenic factors (platelets and thromboxane A 2 production) play an important role [14].…”

Section: Introductionmentioning

confidence: 99%

Vitamin D Deficiency Reduces Vascular Reactivity of Coronary Arterioles in Male Rats

Fontányi

Sziva

Pál

et al. 2021

CIMB

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Background: Vitamin D deficiency (VDD) may be considered an independent cardiovascular (CV) risk factor, and it is well known that CV risk is higher in males. Our goal was to investigate the pharmacological reactivity and receptor expression of intramural coronary artery segments of male rats in cases of different vitamin D supply. Methods: Four-week-old male Wistar rats were divided into a control group (n = 11) with optimal vitamin D supply (300 IU/kgbw/day) and a VDD group (n = 11, <0.5 IU/kgbw/day). After 8 weeks of treatment, intramural coronary artery segments were microprepared, their pharmacological reactivity was examined by in vitro microangiometry, and their receptor expression was investigated by immunohistochemistry. Results: Thromboxane A2 (TXA2)-agonist induced reduced vasoconstriction, testosterone (T) and 17-β-estradiol (E2) relaxations were significantly decreased, a significant decrease in thromboxane receptor (TP) expression was shown, and the reduction in estrogen receptor-α (ERα) expression was on the border of significance in the VDD group. Conclusions: VD-deficient male coronary arteries showed deteriorated pharmacological reactivity to TXA2 and sexual steroids (E2, T). Insufficient vasoconstrictor capacity was accompanied by decreased TP receptor expression, and vasodilator impairments were mainly functional. The decrease in vasoconstrictor and vasodilator responses results in narrowed adaptational range of coronaries, causing inadequate coronary perfusion that might contribute to the increased CV risk in VDD.

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Sex-Based Considerations in the Evaluation of Chest Pain and Management of Obstructive Coronary Artery Disease

Cited by 7 publications

References 107 publications

Geschlechtsspezifische Unterschiede bei koronarer Herzerkrankung

Geschlechtsspezifische Unterschiede bei koronarer Herzerkrankung

Sex Differences in Molecular Mechanisms of Cardiovascular Aging

Vitamin D Deficiency Reduces Vascular Reactivity of Coronary Arterioles in Male Rats

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