Gender differences in outcome after coronary revascularization

Abstract

Women were associated with greater short-term mortality following coronary revascularization, mainly driven by older age and greater prevalence of comorbidities. Long-term outcomes after coronary revascularization are similar between men and women, or even better in women. Intracoronary imaging studies showed fewer “high-risk” plaques in women as compared with men. While there was a significant difference in coronary flow reserve between men and women, the importance of this observation remains to be determined. There were significant sex difference in diagnostic testing and managements, while it remains unclear whether there are sex-specific differences in the clinical phenotype of coronary artery disease, or in sex-specific bias of diagnostic testing, or both. In patients who undergo percutaneous coronary intervention, newer generation drug-eluting stents are recommended for use in both men and women based on the currently available evidences. In conclusion, sex difference in coronary disease burden, coronary physiology, response to diagnostic testing, and clinical management may play an important role in the observed difference in clinical outcomes between men and women. Further studies are needed to elucidate sex differences following coronary revascularization.