Title:Atheroma Burden and Morphology in Women
Volume: 22
Issue: 25
Author(s): Lina Badimon, María Borrell-Pagès and Teresa Padró
Affiliation:
Keywords:
Women, cardiovascular risk factors, ischemic heart disease, coronary arteries, microvascular disease, endothelial dysfunction,
plaque erosion, plaque rupture, steroid hormones, menopause.
Abstract: Background: Ischemic heart disease is the major cause of death in women. Men
and women have many similarities in relation to cardiovascular risk factors, but they differ
in the pathophysiology, clinical presentation and outcomes in the setting of coronary artery
disease and myocardial ischemia. Over the last years, due to innovative imaging technologies
and more specific diagnostic strategies, increasing number of clinical studies report on
specific-gender characteristics on plaque composition and burden, associated to acute coronary
syndromes, and also on coronary vascular dysfunction as a major cause of clinical
symptoms in women with apparently normal arteries. Methods: Here we performed a review
of the literature focused on atheroma burden in women that includes information provided in
original articles (basic and clinical oriented), cohort studies, trial and registry data, metaanalysis
and other systematic reviews. Results and Conclusions: The Studies published over
the last 30 years provide a new view about the pathophysiology and presentation of ischemic
heart disease in women. However, many questions remain to be addressed by future research. The mechanisms
behind the delay on disease presentation in women over the fertile period and the paradoxical fact that young
women have more adverse outcomes after an ischemic event need to be identified. A better understanding of
these issues is expected to derive in better strategies for prevention and management of ischemic heart disease in
women.
