About this Research Topic
This Research Topic is the second volume of the 'The Role of Sex in Coronary Artery Disease' Please find the first volume here.
Coronary artery disease (CAD) is among the leading causes of mortality and morbidity worldwide, and many environmental and genetic risk factors contribute to its development, progression, and outcome. There is a misconception that CAD is primarily a man's disease, yet women are more likely to have far worse clinical outcomes than men following CAD-related events. Despite recent advances against CAD with a reduction in mortality rates in both sexes, women have higher CAD-related death rates. In addition, they are still underdiagnosed and undermanaged (both medically and interventionally), and underrepresented in CAD clinical trials, with consequent influence on disease outcome.
Sex and gender differences play a major role in the epidemiology, aetiology, and pathophysiology as well as clinical manifestations, diagnosis, treatment, and prognosis of CAD. Sex refers to biological and physiological differences, whereas gender refers to differences uniquely related to humans, including those related to women's and men's environments, lifestyles, and attitudes. Women frequently present with atypical clinical pictures being considered non-cardiac symptoms. This, in addition to psychosocial factors, may lead to the underdiagnosis of CAD in women. Furthermore, women are more likely to show myocardial ischemia independent of coronary stenosis (i.e., non-obstructive CAD) than men. Non-obstructive CAD is associated with coronary microvascular disease that is more often seen in women compared to men. Therefore, microvascular disease diagnosis by measuring coronary blood flow reserve is warranted since symptomatic men and women with non-obstructive CAD have an increased risk for obstructive CAD.
Based on the aforementioned evidence, a conclusion can be made that the current gender-neutral guidelines on CAD prevention, development, and management may need to be revised. However, further studies are required to determine whether sex-based diagnostic modalities and treatment can improve the morbidity and mortality of women and men with CAD. Therefore, this research topic aims to collect and publish data on the differences between men and women in awareness, risk factors, pathophysiology, prevention, clinical presentation, diagnostic evaluation, and management of CAD.
Sub-themes in this Research Topic will include:
1) The differences in the cardiovascular risk factors between men and women and their modification.
2) Association of sex hormones and the development of CAD.
3) Sex-related mechanisms of CAD.
4) Non-obstructive CAD.
5) Microvascular disease.
6) Future perspectives in diagnosis and treatment.
7) Sex and gender differences related to the pharmacokinetics of cardiac drugs.
8) The risk of CAD in women before the menopause.
We are particularly interested in clinical and translational manuscripts, including Original Research, Reviews, and Systematic Reviews/meta-analyses, but well-designed basic studies with clear translational implications are also welcomed.
Coronary artery disease (CAD) is among the leading causes of mortality and morbidity worldwide, and many environmental and genetic risk factors contribute to its development, progression, and outcome. There is a misconception that CAD is primarily a man's disease, yet women are more likely to have far worse clinical outcomes than men following CAD-related events. Despite recent advances against CAD with a reduction in mortality rates in both sexes, women have higher CAD-related death rates. In addition, they are still underdiagnosed and undermanaged (both medically and interventionally), and underrepresented in CAD clinical trials, with consequent influence on disease outcome.
Sex and gender differences play a major role in the epidemiology, aetiology, and pathophysiology as well as clinical manifestations, diagnosis, treatment, and prognosis of CAD. Sex refers to biological and physiological differences, whereas gender refers to differences uniquely related to humans, including those related to women's and men's environments, lifestyles, and attitudes. Women frequently present with atypical clinical pictures being considered non-cardiac symptoms. This, in addition to psychosocial factors, may lead to the underdiagnosis of CAD in women. Furthermore, women are more likely to show myocardial ischemia independent of coronary stenosis (i.e., non-obstructive CAD) than men. Non-obstructive CAD is associated with coronary microvascular disease that is more often seen in women compared to men. Therefore, microvascular disease diagnosis by measuring coronary blood flow reserve is warranted since symptomatic men and women with non-obstructive CAD have an increased risk for obstructive CAD.
Based on the aforementioned evidence, a conclusion can be made that the current gender-neutral guidelines on CAD prevention, development, and management may need to be revised. However, further studies are required to determine whether sex-based diagnostic modalities and treatment can improve the morbidity and mortality of women and men with CAD. Therefore, this research topic aims to collect and publish data on the differences between men and women in awareness, risk factors, pathophysiology, prevention, clinical presentation, diagnostic evaluation, and management of CAD.
Sub-themes in this Research Topic will include:
1) The differences in the cardiovascular risk factors between men and women and their modification.
2) Association of sex hormones and the development of CAD.
3) Sex-related mechanisms of CAD.
4) Non-obstructive CAD.
5) Microvascular disease.
6) Future perspectives in diagnosis and treatment.
7) Sex and gender differences related to the pharmacokinetics of cardiac drugs.
8) The risk of CAD in women before the menopause.
We are particularly interested in clinical and translational manuscripts, including Original Research, Reviews, and Systematic Reviews/meta-analyses, but well-designed basic studies with clear translational implications are also welcomed.
Keywords: Sex, Gender, Ischemic heart disease, Non-occlusive coronary artery disease, Coronary microvascular disease, Diagnostic tests, Coronary revascularization, Clinical outcomes, prognosis
Important Note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.
