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VIEWPOINT

Women, Ischemic Heart Disease, Revascularization, and the Gender Gap

What Are We Missing?

Section of Cardiology, Boston University Medical Center, Boston, Massachusetts

Manuscript received November 1, 2004; accepted December 21, 2004.

^_* Reprint requests and correspondence: Dr. Alice K. Jacobs, Section of Cardiology, Boston University Medical Center, 88 East Newton Street, Boston, Massachusetts 02118-2308 (Email: alice.jacobs{at}bmc.org).

During the past three decades, numerous reports from single-center databases, multicenter registries, and a few randomized trials in patients with ischemic heart disease (IHD) undergoing revascularization with both coronary artery bypass grafting and percutaneous coronary intervention have noted remarkably consistent gender differences in clinical, angiographic, and procedural factors and an increased morbidity and mortality in women. Explanations such as alternative markers of atherosclerosis and novel risk factors in women, gender-specific measures of left ventricular function, and the relationship between disorders more common in women with IHD and adverse cardiovascular outcomes are beginning to unfold.

Abbreviations and Acronyms   CABG = coronary artery bypass grafting   CASS = Coronary Artery Surgical Study   IHD = ischemic heart disease   LV = left ventricular   PCI = percutaneous coronary intervention   WISE = Women’s Ischemia Syndrome Evaluation

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