Metabolic syndrome (MetS) represents a cluster of metabolic disorders that arise from insulin resistance
(IR) and adipose tissue dysfunction. As a consequence, there is an increased risk for type 2 diabetes mellitus
and atherosclerotic cardiovascular disease (CVD). MetS is associated with a 2-fold increase in cardiovascular
outcomes. Earlier population analyses showed a lower prevalence of MetS in women (23.9%) in comparison
to men (27.8%), while later analyses suggest significantly reduced difference due to an increase in the prevalence
in women aged between 20 and 39. However, the prevalence of MetS in specific populations of women,
such as in women with polycystic ovary syndrome, ranges from 16% to almost 50% in some geographical regions.
Abdominal fat accumulation and IR syndrome are recognized as the most important factors in the pathogenesis
of MetS. After menopause, a decline in insulin sensitivity corresponds to an increase in fat mass, circulating
fatty acids, low-density lipoproteins, and triglycerides. Prevalence of MetS in acute coronary syndrome
(ACS) is significantly more present in women (55.9%-66.3%) than in men (40.2%-47.3%) in different cohorts.
Younger women with ACS had a higher mortality rate than younger men. Acute myocardial infarction (AMI)
remains a leading cause of death in aging women. Women with AMI had significantly higher rates of prior congestive
heart failure, hypertension history, and diabetes. The role of androgens in CVD pathogenesis in women
has not yet been clarified. The current review aims to provide an insight into the role of MetS components and
inflammation for the development of atherosclerosis, CVD, and AMI in women.