Sex differences in the diagnostic evaluation of coronary artery disease
Division of Cardiology, Department of Medicine, Stanford University, Stanford, CA, USA.Journal of Nuclear Cardiology (Impact Factor: 2.94). 02/2011; 18(1):144-52. DOI: 10.1007/s12350-010-9315-2
Although sex differences in coronary heart disease (CHD) have long been recognized, many of the recommendations for the management of female patients continue to be identical to male patients. Given the paucity of sex-specific data in basic science and clinical studies, however, defining unique diagnostic and therapeutic strategies for women remains problematic for scientists and clinicians. For instance, women represent only 38% of subjects in previously NIH-funded cardiovascular studies. 1 Previous studies and clinical trials have also included inadequate numbers of women. Finally, only 25% of previous cardiovascular clinical trials have reported sex-specific results. 2 Recently, researchers have been encouraged to report sex differences in basic and clinical studies. Much of the impetus originates from data indicating that more women die of cardiovascular disease (CVD) than men. 3 This disparity in mortality may signal the need for sex-specific guidelines for the diagnosis of CHD. In this review, we will discuss sex differences in the clinical manifestations and outcome of CHD, the limitations of current approaches for the management of female patients, and the potential strategies to improve the evaluation of CHD in women.