Abstract
Mortality decline in women to a lesser extent than in men with coronary artery disease (CAD) has provoked a bigger interest in some already existing dilemmas and questions. Many studies carried out in the past three decades did not provide us with precise conclusions. Moreover, various challenges in the prevention, diagnosis, treatment and outcome of CAD in women are still remaining. The meta-analysis and the systematic review conducted in the last years have offered novel approaches to understanding CAD gender disparities in access to care and coronary disease management in women, but women are more likely to experience less favorable short- and long-term outcomes than men do. The reasons for these findings should lie in several known segments in the CAD pathophysiological mechanisms different in women and ultimately leading to a lower quality of care. Clinical presentation in women, which is often characterized by atypical chest pain and a higher prevalence of non-obstructive CAD when evaluated invasively, places women to the false-negative diagnosis of CAD and influences inadequate access to care. Clinical presentation and diagnostic methods, as well as the appropriate treatment options insufficiently examined in women, need to be better defined. The traditional CAD risk factors have a greater impact on women than on men. Unique CAD risk factors only seen in women, have recently been recognized with more attention. However, it is important to note that even in women with obstructive CAD and typical clinical presentation, invasive therapy and pharmacologic therapy are not always implemented as recommended by guidelines as in men. Women are underrepresented in CAD trials, and in current guidelines, gender differences in CAD management have not yet been justified. The underestimation of the risk of CAD in women, followed by its underdiagnosis and undertreatment, might be one of the reasons for a worse prognosis in women in comparison with men.
Keywords: Coronary artery disease, non-obstructive coronary disease, women, gender differences, acute coronary syndrome, mortality studies, treatment.
Current Pharmaceutical Design
Title:Gender Disparities on Access to Care and Coronary Disease Management
Volume: 27 Issue: 29
Author(s): Zorana Vasiljevic-Pokrajcic*, Gordana Krljanac, Ratko Lasica, Marija Zdravkovic, Sanja Stankovic, Predrag Mitrovic, Vladan Vukcevic and Milika Asanin
Affiliation:
- Medical Faculty, University of Belgrade, Doktora Subotica 8, Belgrade,Serbia
Keywords: Coronary artery disease, non-obstructive coronary disease, women, gender differences, acute coronary syndrome, mortality studies, treatment.
Abstract: Mortality decline in women to a lesser extent than in men with coronary artery disease (CAD) has provoked a bigger interest in some already existing dilemmas and questions. Many studies carried out in the past three decades did not provide us with precise conclusions. Moreover, various challenges in the prevention, diagnosis, treatment and outcome of CAD in women are still remaining. The meta-analysis and the systematic review conducted in the last years have offered novel approaches to understanding CAD gender disparities in access to care and coronary disease management in women, but women are more likely to experience less favorable short- and long-term outcomes than men do. The reasons for these findings should lie in several known segments in the CAD pathophysiological mechanisms different in women and ultimately leading to a lower quality of care. Clinical presentation in women, which is often characterized by atypical chest pain and a higher prevalence of non-obstructive CAD when evaluated invasively, places women to the false-negative diagnosis of CAD and influences inadequate access to care. Clinical presentation and diagnostic methods, as well as the appropriate treatment options insufficiently examined in women, need to be better defined. The traditional CAD risk factors have a greater impact on women than on men. Unique CAD risk factors only seen in women, have recently been recognized with more attention. However, it is important to note that even in women with obstructive CAD and typical clinical presentation, invasive therapy and pharmacologic therapy are not always implemented as recommended by guidelines as in men. Women are underrepresented in CAD trials, and in current guidelines, gender differences in CAD management have not yet been justified. The underestimation of the risk of CAD in women, followed by its underdiagnosis and undertreatment, might be one of the reasons for a worse prognosis in women in comparison with men.
Export Options
About this article
Cite this article as:
Vasiljevic-Pokrajcic Zorana *, Krljanac Gordana , Lasica Ratko , Zdravkovic Marija , Stankovic Sanja , Mitrovic Predrag , Vukcevic Vladan and Asanin Milika , Gender Disparities on Access to Care and Coronary Disease Management, Current Pharmaceutical Design 2021; 27 (29) . https://dx.doi.org/10.2174/1381612827666210406144310
DOI https://dx.doi.org/10.2174/1381612827666210406144310 |
Print ISSN 1381-6128 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4286 |
Call for Papers in Thematic Issues
"Tuberculosis Prevention, Diagnosis and Drug Discovery"
The Nobel Prize-winning discoveries of Mycobacterium tuberculosis and streptomycin have enabled an appropriate diagnosis and an effective treatment of tuberculosis (TB). Since then, many newer diagnosis methods and drugs have been saving millions of lives. Despite advances in the past, TB is still a leading cause of infectious disease mortality ...read more
Current Pharmaceutical challenges in the treatment and diagnosis of neurological dysfunctions
Neurological dysfunctions (MND, ALS, MS, PD, AD, HD, ALS, Autism, OCD etc..) present significant challenges in both diagnosis and treatment, often necessitating innovative approaches and therapeutic interventions. This thematic issue aims to explore the current pharmaceutical landscape surrounding neurological disorders, shedding light on the challenges faced by researchers, clinicians, and ...read more
Emerging and re-emerging diseases
Faced with a possible endemic situation of COVID-19, the world has experienced two important phenomena, the emergence of new infectious diseases and/or the resurgence of previously eradicated infectious diseases. Furthermore, the geographic distribution of such diseases has also undergone changes. This context, in turn, may have a strong relationship with ...read more
Melanoma and Non-Melanoma Skin Cancer Treatment: Standard of Care and Recent Advances
In this thematic issue, we aim to provide a standard of care of the diagnosis and treatment of melanoma and non-melanoma skin cancer. The editor will invite authors from different countries who will write review articles of melanoma and non-melanoma skin cancers. The Diagnosis, Staging, Surgical Treatment, Non-Surgical Treatment all ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
TGR5 as a Therapeutic Target for Treating Obesity
Current Topics in Medicinal Chemistry Targeted Therapies in Bone Sarcomas
Current Cancer Drug Targets Combating Neurodegenerative Diseases with the Plant Alkaloid Berberine: Molecular Mechanisms and Therapeutic Potential
Current Neuropharmacology The Effects of Newer Beta-Adrenoceptor Antagonists on Vascular Function in Cardiovascular Disease
Current Vascular Pharmacology Alcohol Drinking, Apolipoprotein Polymorphisms and the Risk of Cardiovascular Diseases
Current Neurovascular Research Heme Oxygenase-1/CO as Protective Mediators in Cigarette Smoke- Induced Lung Cell Injury and Chronic Obstructive Pulmonary Disease
Current Pharmaceutical Biotechnology Pharmacological Approaches of Binge Drinking
Current Pharmaceutical Design Current Evidence from Phase III Clinical Trials of Selenium Supplementation in Critically Ill Patients: Why Should We Bother?
Mini-Reviews in Medicinal Chemistry The Heart and Brain Imaging in Lone Atrial Fibrillation – Are We Surprised?
Current Pharmaceutical Design Insights into the Role of Matrix Metalloproteinases and Tissue Inhibitor of Metalloproteinases in Health and Disease
Current Chemical Biology Future Therapeutic Strategies in Inflammatory Cardiomyopathy: Insights from the Experimental Autoimmune Myocarditis Model
Cardiovascular & Hematological Disorders-Drug Targets Cardiovascular Involvement in Pediatric Systemic Autoimmune Diseases: The Emerging Role of Noninvasive Cardiovascular Imaging
Inflammation & Allergy - Drug Targets (Discontinued) Functional Variants of the Interleukin-23 Receptor Gene in Non-Gastrointestinal Autoimmune Diseases
Current Medicinal Chemistry Angiotensin Receptor Blockers in Chronic Heart Failure: Clinical Implications and Molecular Mechanisms
Current Cardiology Reviews Frontotemporal Lobar Degeneration (FTLD): Review and Update for Clinical Neurologists
Current Alzheimer Research Vitamins in Heart Failure: Friend or Enemy?
Current Pharmaceutical Design Circulating Biomarkers for the Diagnosis and Prognosis of Heart Failure
Current Medicinal Chemistry Targeting the Inflammatory Response in Healing Myocardial Infarcts
Current Medicinal Chemistry Glucose Intolerance and Diabetes Mellitus in Endocrine Disorders – Two Case Reports and a Review
Current Diabetes Reviews Role of Cardiolipin in Mitochondrial Diseases and Apoptosis
Current Medicinal Chemistry