Skip to main content
SpringerLink
Log in

Ischemic Heart Disease in Women

  • Chapter
  • First Online:
Manual of Gynecardiology

  • 388 Accesses

Abstract

Women have different manifestations of ischemic heart disease (IHD) than men throughout their lifetime. At middle-age they have more often non-obstructive coronary artery disease (NOCAD) and coronary vascular dysfunction rather than obstructive, focal coronary artery disease (CAD). Differences in underlying pathophysiology translate into a different presentation of symptoms among both genders. This needs a more gender-sensitive diagnostic and therapeutic approach as discussed in this chapter.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Burke AP, Farb A, Malcom G, Virmani R. Effect of menopause on plaque morphologic characteristics in coronary atherosclerosis. Am Heart J. 2001;141(2 Suppl):S58–62.

    Article  CAS  PubMed  Google Scholar 

  2. Frink RJ. Gender gap, inflammation and acute coronary disease: are women resistant to atheroma growth? Observations at autopsy. J Invasive Cardiol. 2009;21(6):270–7.

    PubMed  Google Scholar 

  3. Han SH, Bae JH, Holmes Jr DR, Lennon RJ, Eeckhout E, Barsness GW, et al. Sex differences in atheroma burden and endothelial function in patients with early coronary atherosclerosis. Eur Heart Journal. 2008;29(11):1359–69.

    Article  Google Scholar 

  4. Shaw LJ, Bugiardini R, Merz CN. Women and ischemic heart disease: evolving knowledge. J Am Coll Cardiol. 2009;54(17):1561–75.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Maas AH, van der Schouw YT, Regitz-Zagrosek V, Swahn E, Appelman YE, Pasterkamp G, et al. Red alert for women's heart: the urgent need for more research and knowledge on cardiovascular disease in women: proceedings of the workshop held in Brussels on gender differences in cardiovascular disease, 29 September 2010. Eur Heart J. 2011;32(11):1362–8.

    Article  PubMed  Google Scholar 

  6. EugenMed CC. Study G, Regitz-Zagrosek V, Oertelt-Prigione S, Prescott E, Franconi F, et al. Gender in cardiovascular diseases: impact on clinical manifestations, management, and outcomes. Eur Heart J. 2016;37(1):24–34.

    Article  Google Scholar 

  7. Vaccarino V, Badimon L, Corti R, de Wit C, Dorobantu M, Hall A, et al. Ischaemic heart disease in women: are there sex differences in pathophysiology and risk factors? Position paper from the working group on coronary pathophysiology and microcirculation of the European Society of Cardiology. Cardiovasc Res. 2011;90(1):9–17.

    Article  CAS  PubMed  Google Scholar 

  8. Erbel R, Mohlenkamp S, Kerkhoff G, Budde T, Schmermund A. Non-invasive screening for coronary artery disease: calcium scoring. Heart. 2007;93(12):1620–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Nasir K, Gopal A, Blankstein R, Ahmadi N, Pal R, Khosa F, et al. Noninvasive assessment of gender differences in coronary plaque composition with multidetector computed tomographic angiography. Am J Cardiol. 2010;105(4):453–8.

    Article  PubMed  Google Scholar 

  10. Qureshi W, Blaha MJ, Nasir K, Al-Mallah MH. Gender differences in coronary plaque composition and burden detected in symptomatic patients referred for coronary computed tomographic angiography. Int J Cardiovasc Imaging. 2013;29(2):463–9.

    Article  PubMed  Google Scholar 

  11. Smilowitz NR, Sampson BA, Abrecht CR, Siegfried JS, Hochman JS, Reynolds HR. Women have less severe and extensive coronary atherosclerosis in fatal cases of ischemic heart disease: an autopsy study. Am Heart J. 2011;161(4):681–8.

    Article  PubMed  Google Scholar 

  12. Jacobs AK. Coronary intervention in 2009: are women no different than men? Circ Cardiovasc Interv. 2009;2(1):69–78.

    Article  PubMed  Google Scholar 

  13. Johnston N, Schenck-Gustafsson K, Lagerqvist B. Are we using cardiovascular medications and coronary angiography appropriately in men and women with chest pain? Eur Heart J. 2011;32(11):1331–6.

    Article  PubMed  Google Scholar 

  14. Shaw LJ, Min JK, Narula J, Lin F, Bairey-Merz CN, Callister TQ, et al. Sex differences in mortality associated with computed tomographic angiographic measurements of obstructive and nonobstructive coronary artery disease: an exploratory analysis. Circ Cardiovasc Imaging. 2010;3(4):473–81.

    Article  PubMed  Google Scholar 

  15. Raggi P, Gongora MC, Gopal A, Callister TQ, Budoff M, Shaw LJ. Coronary artery calcium to predict all-cause mortality in elderly men and women. J Am Coll Cardiol. 2008;52(1):17–23.

    Article  PubMed  Google Scholar 

  16. Sedlak TL, Lee M, Izadnegahdar M, Merz CN, Gao M, Humphries KH. Sex differences in clinical outcomes in patients with stable angina and no obstructive coronary artery disease. Am Heart J. 2013;166(1):38–44.

    Article  PubMed  Google Scholar 

  17. Gulati M, Cooper-DeHoff RM, McClure C, Johnson BD, Shaw LJ, Handberg EM, et al. Adverse cardiovascular outcomes in women with nonobstructive coronary artery disease: a report from the Women's Ischemia Syndrome Evaluation Study and the St James Women Take Heart Project. Arch Intern Med. 2009;169(9):843–50.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Sharaf B, Wood T, Shaw L, Johnson BD, Kelsey S, Anderson RD, et al. Adverse outcomes among women presenting with signs and symptoms of ischemia and no obstructive coronary artery disease: findings from the National Heart, Lung, and Blood Institute-sponsored Women's Ischemia Syndrome Evaluation (WISE) angiographic core laboratory. Am Heart J. 2013;166(1):134–41.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Jespersen L, Hvelplund A, Abildstrom SZ, Pedersen F, Galatius S, Madsen JK, et al. Stable angina pectoris with no obstructive coronary artery disease is associated with increased risks of major adverse cardiovascular events. Eur Heart J. 2012;33(6):734–44.

    Article  PubMed  Google Scholar 

  20. Narula J, Strauss HW. The popcorn plaques. Nat Med. 2007;13(5):532–4.

    Article  CAS  PubMed  Google Scholar 

  21. Colombo A, Panoulas VF. Diagnostic coronary angiography is getting old! JACC Cardiovasc Imaging. 2015;8(1):11–3.

    Article  PubMed  Google Scholar 

  22. Gaemperli O, Luscher TF, Bax JJ. View point: what should the future design of clinical imaging studies be? Eur Heart J. 2013;34(31):2432–5.

    Article  PubMed  Google Scholar 

  23. Pepine CJ, Ferdinand KC, Shaw LJ, Light-McGroary KA, Shah RU, Gulati M, et al. Emergence of Nonobstructive Coronary Artery Disease: A Woman's Problem and Need for Change in Definition on Angiography. J Am Coll Cardiol. 2015;66(17):1918–33.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Garcia M, Mulvagh SL, Bairey Merz CN, Buring JE, Manson JE. Cardiovascular Disease in Women: Clinical Perspectives. Circ Res. 2016;118(8):1273–93.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Khuddus MA, Pepine CJ, Handberg EM, Bairey Merz CN, Sopko G, Bavry AA, et al. An intravascular ultrasound analysis in women experiencing chest pain in the absence of obstructive coronary artery disease: a substudy from the National Heart, Lung and Blood Institute-Sponsored Women's Ischemia Syndrome Evaluation (WISE). J Interv Cardiol. 2010;23(6):511–9.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Maddox TM, Stanislawski MA, Grunwald GK, Bradley SM, Ho PM, Tsai TT, et al. Nonobstructive coronary artery disease and risk of myocardial infarction. JAMA. 2014;312(17):1754–63.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Marzilli M, Merz CN, Boden WE, Bonow RO, Capozza PG, Chilian WM, et al. Obstructive coronary atherosclerosis and ischemic heart disease: an elusive link! J Am Coll Cardiol. 2012;60(11):951–6.

    Article  PubMed  Google Scholar 

  28. Tonino PA, Fearon WF, De Bruyne B, Oldroyd KG, Leesar MA, Ver Lee PN, et al. Angiographic versus functional severity of coronary artery stenoses in the FAME study fractional flow reserve versus angiography in multivessel evaluation. J Am Coll Cardiol. 2010;55(25):2816–21.

    Article  PubMed  Google Scholar 

  29. Chen SL, Xu B, Chen JB, Xu T, Ye F, Zhang JJ, et al. Diagnostic accuracy of quantitative angiographic and intravascular ultrasound parameters predicting the functional significance of single de novo lesions. Int J Cardiol. 2013;168(2):1364–9.

    Article  PubMed  Google Scholar 

  30. Fihn SD, Gardin JM, Abrams J, Berra K, Blankenship JC, Dallas AP, et al. 2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the diagnosis and management of patients with stable ischemic heart disease: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, and the American College of Physicians, American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol. 2012;60(24):e44–e164.

    Google Scholar 

  31. Task Force Members, Montalescot G, Sechtem U, Achenbach S, Andreotti F, Arden C, et al. 2013 ESC guidelines on the management of stable coronary artery disease: the Task Force on the management of stable coronary artery disease of the European Society of Cardiology. Eur Heart J. 2013;34(38):2949–3003.

    Article  Google Scholar 

  32. Robinson JG, Wallace R, Limacher M, Ren H, Cochrane B, Wassertheil-Smoller S, et al. Cardiovascular risk in women with non-specific chest pain (from the Women's Health Initiative Hormone Trials). Am J Cardiol. 2008;102(6):693–9.

    Article  PubMed  Google Scholar 

  33. Jespersen L, Abildstrom SZ, Hvelplund A, Madsen JK, Galatius S, Pedersen F, et al. Burden of hospital admission and repeat angiography in angina pectoris patients with and without coronary artery disease: a registry-based cohort study. PLoS One. 2014;9(4):e93170.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Mosca L, Linfante AH, Benjamin EJ, Berra K, Hayes SN, Walsh BW, et al. National study of physician awareness and adherence to cardiovascular disease prevention guidelines. Circulation. 2005;111(4):499–510.

    Article  PubMed  Google Scholar 

  35. Pepine CJ, Balaban RS, Bonow RO, Diamond GA, Johnson BD, Johnson PA, et al. Women's Ischemic Syndrome Evaluation: current status and future research directions: report of the National Heart, Lung and Blood Institute workshop: October 2-4, 2002: Section 1: diagnosis of stable ischemia and ischemic heart disease. Circulation. 2004;109(6):e44–6.

    Article  PubMed  Google Scholar 

  36. Eastwood JA, Johnson BD, Rutledge T, Bittner V, Whittaker KS, Krantz DS, et al. Anginal symptoms, coronary artery disease, and adverse outcomes in Black and White women: the NHLBI-sponsored Women's Ischemia Syndrome Evaluation (WISE) study. J Women's Health. 2013;22(9):724–32.

    Article  Google Scholar 

  37. Hemingway H, Langenberg C, Damant J, Frost C, Pyorala K, Barrett-Connor E. Prevalence of angina in women versus men: a systematic review and meta-analysis of international variations across 31 countries. Circulation. 2008;117(12):1526–36.

    Article  PubMed  Google Scholar 

  38. Kreatsoulas C, Shannon HS, Giacomini M, Velianou JL, Anand SS. Reconstructing angina: cardiac symptoms are the same in women and men. JAMA Intern Med. 2013;173(9):829–31.

    Article  PubMed  Google Scholar 

  39. Merz AA, Cheng S. Sex differences in cardiovascular ageing. Heart. 2016;102(11):825–31.

    Google Scholar 

  40. Pedrotty DM, Jessup M. "Frailty, thy name is woman": syndrome of women with heart failure with preserved ejection fraction. Circ Cardiovasc Qual Outcomes. 2015;8(2 Suppl 1):S48–51.

    Article  PubMed  Google Scholar 

  41. Elderkin-Thompson V, Waitzkin H. Differences in clinical communication by gender. J Gen Intern Med. 1999;14(2):112–21.

    Article  CAS  PubMed  Google Scholar 

  42. Diamond GA, Forrester JS. Analysis of probability as an aid in the clinical diagnosis of coronary-artery disease. N Engl J Med. 1979;300(24):1350–8.

    Article  CAS  PubMed  Google Scholar 

  43. Genders TS, Steyerberg EW, Alkadhi H, Leschka S, Desbiolles L, Nieman K, et al. A clinical prediction rule for the diagnosis of coronary artery disease: validation, updating, and extension. Eur Heart J. 2011;32(11):1316–30.

    Article  PubMed  Google Scholar 

  44. Fordyce CB, Douglas PS. Optimal non-invasive imaging test selection for the diagnosis of ischaemic heart disease. Heart. 2016;102(7):555–64.

    Google Scholar 

  45. Wolk MJ, Bailey SR, Doherty JU, Douglas PS, Hendel RC, Kramer CM, et al. ACCF/AHA/ASE/ASNC/HFSA/HRS/SCAI/SCCT/SCMR/STS 2013 multimodality appropriate use criteria for the detection and risk assessment of stable ischemic heart disease: a report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Failure Society of America, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and Society of Thoracic Surgeons. J Am Coll Cardiol. 2014;63(4):380–406.

    Google Scholar 

  46. Ng VG, Meller S, Shetty S, Lansky AJ. Diagnosing and characterizing coronary artery disease in women: developments in noninvasive and invasive imaging techniques. J Cardiovasc Transl Res. 2013;6(5):740–51.

    Article  PubMed  Google Scholar 

  47. Douglas PS, Ginsburg GS. The evaluation of chest pain in women. N Engl J Med. 1996;334(20):1311–5.

    Article  CAS  PubMed  Google Scholar 

  48. Mieres JH, Shaw LJ, Arai A, Budoff MJ, Flamm SD, Hundley WG, et al. Role of noninvasive testing in the clinical evaluation of women with suspected coronary artery disease: Consensus statement from the Cardiac Imaging Committee, Council on Clinical Cardiology, and the Cardiovascular Imaging and Intervention Committee, Council on Cardiovascular Radiology and Intervention. American Heart Association Circulation. 2005;111(5):682–96.

    PubMed  Google Scholar 

  49. Mosca L, Benjamin EJ, Berra K, Bezanson JL, Dolor RJ, Lloyd-Jones DM, et al. Effectiveness-based guidelines for the prevention of cardiovascular disease in women--2011 update: a guideline from the american heart association. Circulation. 2011;123(11):1243–62.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Piepoli MF, Hoes AW, Agewall S, Albus C, Brotons C, Catapano AL, et al. 2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts): Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J. 2016. 37(29):2315–81.

    Google Scholar 

  51. Mieres JH, Gulati M, Bairey Merz N, Berman DS, Gerber TC, Hayes SN, et al. Role of noninvasive testing in the clinical evaluation of women with suspected ischemic heart disease: a consensus statement from the American Heart Association. Circulation. 2014;130(4):350–79.

    Article  PubMed  Google Scholar 

  52. Mieres JH, Shaw LJ, Wenger NK. Noninvasive testing in women with suspected ischemic heart disease: ten highlights to guide quality clinical care. Clin Cardiol. 2014;37(9):515–6.

    Article  PubMed  Google Scholar 

  53. Douglas PS, Hoffmann U, Patel MR, Mark DB, Al-Khalidi HR, Cavanaugh B, et al. Outcomes of anatomical versus functional testing for coronary artery disease. N Engl J Med. 2015;372(14):1291–300.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  54. Hemal K, Pagidipati NJ, Coles A, Dolor RJ, Mark DB, Pellikka PA, et al. Sex Differences in Demographics, Risk Factors, Presentation, and Noninvasive Testing in Stable Outpatients With Suspected Coronary Artery Disease: Insights From the PROMISE Trial. JACC Cardiovasc Imaging. 2016;9(4):337–46.

    Article  PubMed  PubMed Central  Google Scholar 

  55. Pagidipati NJ, Hemal K, Coles A, Mark DB, Dolor RJ, Pellikka PA, et al. Sex Differences in Functional and CT Angiography Testing in Patients With Suspected Coronary Artery Disease. J Am Coll Cardiol. 2016;67(22):2607–16.

    Article  PubMed  PubMed Central  Google Scholar 

  56. Mieres JH, Bonow RO. Ischemic Heart Disease in Women: A Need for Sex-Specific Diagnostic Algorithms. JACC Cardiovasc Imaging. 2016;9(4):347–9.

    Article  PubMed  Google Scholar 

  57. Min JK, Leipsic J, Pencina MJ, Berman DS, Koo BK, van Mieghem C, et al. Diagnostic accuracy of fractional flow reserve from anatomic CT angiography. JAMA. 2012;308(12):1237–45.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  58. Patel MR, Dai D, Hernandez AF, Douglas PS, Messenger J, Garratt KN, et al. Prevalence and predictors of nonobstructive coronary artery disease identified with coronary angiography in contemporary clinical practice. Am Heart J. 2014;167(6):846–52. e2

    Article  PubMed  Google Scholar 

  59. Tonino PA, De Bruyne B, Pijls NH, Siebert U, Ikeno F. van' t Veer M, et al. Fractional flow reserve versus angiography for guiding percutaneous coronary intervention. N Engl J Med. 2009;360(3):213–24.

    Article  CAS  PubMed  Google Scholar 

  60. Tamis-Holland JE, Lu J, Korytkowski M, Magee M, Rogers WJ, Lopes N, et al. Sex differences in presentation and outcome among patients with type 2 diabetes and coronary artery disease treated with contemporary medical therapy with or without prompt revascularization: a report from the BARI 2D Trial (Bypass Angioplasty Revascularization Investigation 2 Diabetes). J Am Coll Cardiol. 2013;61(17):1767–76.

    Article  PubMed  Google Scholar 

  61. Mega JL, Hochman JS, Scirica BM, Murphy SA, Sloan S, McCabe CH, et al. Clinical features and outcomes of women with unstable ischemic heart disease: observations from metabolic efficiency with ranolazine for less ischemia in non-ST-elevation acute coronary syndromes-thrombolysis in myocardial infarction 36 (MERLIN-TIMI 36). Circulation. 2010;121(16):1809–17.

    Article  PubMed  Google Scholar 

  62. Kok MM, van der Heijden LC, Sen H, Danse PW, Lowik MM, Anthonio RL, et al. Sex Difference in Chest Pain After Implantation of Newer Generation Coronary Drug-Eluting Stents: A Patient-Level Pooled Analysis From the TWENTE and DUTCH PEER Trials. JACC Cardiovasc Interv. 2016;9(6):553–61.

    Article  PubMed  Google Scholar 

  63. De Bruyne B, Fearon WF, Pijls NH, Barbato E, Tonino P, Piroth Z, et al. Fractional flow reserve-guided PCI for stable coronary artery disease. N Engl J Med. 2014;371(13):1208–17.

    Article  PubMed  Google Scholar 

  64. Chandrasekhar J, Mehran R. Sex-Based Differences in Acute Coronary Syndromes: Insights From Invasive and Noninvasive Coronary Technologies. JACC Cardiovasc Imaging. 2016;9(4):451–64.

    Article  PubMed  Google Scholar 

  65. Li J, Rihal CS, Matsuo Y, Elrashidi MY, Flammer AJ, Lee MS, et al. Sex-related differences in fractional flow reserve-guided treatment. Circ Cardiovasc Interv. 2013;6(6):662–70.

    Article  PubMed  PubMed Central  Google Scholar 

  66. Kang SJ, Ahn JM, Han S, Lee JY, Kim WJ, Park DW, et al. Sex differences in the visual-functional mismatch between coronary angiography or intravascular ultrasound versus fractional flow reserve. JACC Cardiovasc Interv. 2013;6(6):562–8.

    Article  PubMed  Google Scholar 

  67. Stefanini GG, Baber U, Windecker S, Morice MC, Sartori S, Leon MB, et al. Safety and efficacy of drug-eluting stents in women: a patient-level pooled analysis of randomised trials. Lancet. 2013;382(9908):1879–88.

    Article  CAS  PubMed  Google Scholar 

  68. Bertrand OF, Belisle P, Joyal D, Costerousse O, Rao SV, Jolly SS, et al. Comparison of transradial and femoral approaches for percutaneous coronary interventions: a systematic review and hierarchical Bayesian meta-analysis. Am Heart J. 2012;163(4):632–48.

    Article  PubMed  Google Scholar 

  69. Shin JS, Tahk SJ, Yang HM, Yoon MH, Choi SY, Choi BJ, et al. Impact of female gender on bleeding complications after transradial coronary intervention (from the Korean Transradial Coronary Intervention registry). Am J Cardiol. 2014;113(12):2002–6.

    Article  PubMed  Google Scholar 

  70. Abdelaal E, Brousseau-Provencher C, Montminy S, Plourde G, MacHaalany J, Bataille Y, et al. Risk score, causes, and clinical impact of failure of transradial approach for percutaneous coronary interventions. JACC Cardiovasc Interv. 2013;6(11):1129–37.

    Article  PubMed  Google Scholar 

  71. Patti G, De Caterina R, Abbate R, Andreotti F, Biasucci LM, Calabro P, et al. Platelet function and long-term antiplatelet therapy in women: is there a gender-specificity? A 'state-of-the-art' paper. Eur Heart J. 2014;35(33):2213-23b.

    Google Scholar 

  72. Mackman N. Triggers, targets and treatments for thrombosis. Nature. 2008;451(7181):914–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  73. Ahmed B, Dauerman HL. Women, bleeding, and coronary intervention. Circulation. 2013;127(5):641–9.

    Article  PubMed  Google Scholar 

  74. Flammer AJ, Anderson T, Celermajer DS, Creager MA, Deanfield J, Ganz P, et al. The assessment of endothelial function: from research into clinical practice. Circulation. 2012;126(6):753–67.

    Article  PubMed  PubMed Central  Google Scholar 

  75. Anderson TJ, Uehata A, Gerhard MD, Meredith IT, Knab S, Delagrange D, et al. Close relation of endothelial function in the human coronary and peripheral circulations. J Am Coll Cardiol. 1995;26(5):1235–41.

    Article  CAS  PubMed  Google Scholar 

  76. Beltrame JF, Crea F, Kaski JC, Ogawa H, Ong P, Sechtem U, et al. International standardization of diagnostic criteria for vasospastic angina. Eur Heart J. 2015. [Epub ahead of print] Review.

    Google Scholar 

  77. Beltrame JF, Crea F, Kaski JC, Ogawa H, Ong P, Sechtem U, et al. The Who, What, Why, When, How and Where of Vasospastic Angina. Circ J. 2016;80(2):289–98.

    Article  PubMed  Google Scholar 

  78. Dallongevillle J, De Bacquer D, Heidrich J, De Backer G, Prugger C, Kotseva K, et al. Gender differences in the implementation of cardiovascular prevention measures after an acute coronary event. Heart. 2010;96(21):1744–9.

    Article  PubMed  Google Scholar 

  79. Daly C, Clemens F, Lopez Sendon JL, Tavazzi L, Boersma E, Danchin N, et al. Gender differences in the management and clinical outcome of stable angina. Circulation. 2006;113(4):490–8.

    Article  PubMed  Google Scholar 

  80. Koopman C, Vaartjes I, Heintjes EM, Spiering W, van Dis I, Herings RM, et al. Persisting gender differences and attenuating age differences in cardiovascular drug use for prevention and treatment of coronary heart disease, 1998-2010. Eur Heart J. 2013;34(41):3198–205.

    Article  CAS  PubMed  Google Scholar 

  81. Oertelt-Prigione S, Regitz-Zagrosek V. Gender aspects in cardiovascular pharmacology. J Cardiovasc Transl Res. 2009;2(3):258–66.

    Article  PubMed  Google Scholar 

  82. Ridker PM, Cook NR, Lee IM, Gordon D, Gaziano JM, Manson JE, et al. A randomized trial of low-dose aspirin in the primary prevention of cardiovascular disease in women. N Engl J Med. 2005;352(13):1293–304.

    Article  CAS  PubMed  Google Scholar 

  83. Abbey M, Owen A, Suzakawa M, Roach P, Nestel PJ. Effects of menopause and hormone replacement therapy on plasma lipids, lipoproteins and LDL-receptor activity. Maturitas. 1999;33(3):259–69.

    Article  CAS  PubMed  Google Scholar 

  84. Souza HC, Tezini GC. Autonomic Cardiovascular Damage during Post-menopause: the Role of Physical Training. Aging and Disease. 2013;4(6):320–8.

    Article  PubMed  PubMed Central  Google Scholar 

  85. Barnes JN, Hart EC, Curry TB, Nicholson WT, Eisenach JH, Wallin BG, et al. Aging enhances autonomic support of blood pressure in women. Hypertension. 2014;63(2):303–8.

    Article  CAS  PubMed  Google Scholar 

  86. Vaccarino V, Lin ZQ, Kasl SV, Mattera JA, Roumanis SA, Abramson JL, et al. Sex differences in health status after coronary artery bypass surgery. Circulation. 2003;108(21):2642–7.

    Article  PubMed  Google Scholar 

  87. Regitz-Zagrosek V, Lehmkuhl E, Hocher B, Goesmann D, Lehmkuhl HB, Hausmann H, et al. Gender as a risk factor in young, not in old, women undergoing coronary artery bypass grafting. J Am Coll Cardiol. 2004;44(12):2413–4.

    Article  PubMed  Google Scholar 

  88. Pollock B, Hamman BL, Sass DM, da Graca B, Grayburn PA, Filardo G. Effect of gender and race on operative mortality after isolated coronary artery bypass grafting. Am J Cardiol. 2015;115(5):614–8.

    Article  PubMed  Google Scholar 

  89. Swaminathan RV, Feldman DN, Pashun RA, Patil RK, Shah T, Geleris JD, et al. Gender differences in in-hospital outcomes after coronary artery bypass grafting. Am J Cardiol. 2016;118(3):362–8.

    Google Scholar 

  90. Trienekens MP, Maas AH, Timman ST, Van Swieten HA, Noyez L. Sex differences in patient and procedural characteristics and early outcomes following cardiac surgery. J Cardiovasc Surg. 2015;56(5):817–23.

    CAS  Google Scholar 

  91. Swaminathan RV, Feldman DN, Pashun RA, Patil RK, Shah T, Geleris JD, et al. Gender Differences in In-Hospital Outcomes After Coronary Artery Bypass Grafting. Am J Cardiol. 2016;118(3):362–8.

    Article  PubMed  Google Scholar 

  92. Ferreira RG, Worthington A, Huang CC, Aranki SF, Muehlschlegel JD. Sex differences in the prevalence of diastolic dysfunction in cardiac surgical patients. J Card Surg. 2015;30(3):238–45.

    Article  PubMed  PubMed Central  Google Scholar 

  93. Lehmkuhl E, Kendel F, Gelbrich G, Dunkel A, Oertelt-Prigione S, Babitsch B, et al. Gender-specific predictors of early mortality after coronary artery bypass graft surgery. Clin Res Cardiol. 2012;101(9):745–51.

    Article  CAS  PubMed  Google Scholar 

  94. Dalen M, Lund LH, Ivert T, Holzmann MJ, Sartipy U. Survival after coronary artery bypass grafting in patients with preoperative heart failure and preserved vs. reduced ejection fraction. JAMA Cardiol. 2016;1(5):530–8.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Cardiology, Women’s Cardiac Health Program, Radboud University Medical Center, Nijmegen, The Netherlands

    Angela H. E. M. Maas M.D., Ph.D.

  2. Barbra Streisand Women’s Heart Center, Linda Joy Pollin Women’s Heart Health Program, Director Preventive Cardiac Center, Cedars-Sinai, Los Angeles, USA

    C. Noel Bairey Merz M.D. (Director)

Authors
  1. Angela H. E. M. Maas M.D., Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. C. Noel Bairey Merz M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Angela H. E. M. Maas M.D., Ph.D. .

Editor information

Editors and Affiliations

  1. Department of Cardiology, Women’s Cardiac Health Program, Radboud University Medical Center, Nijmegen, The Netherlands

    Angela H.E.M. Maas

  2. Director Barbra Streisand Women’s Heart Center, Linda Joy Pollin Women’s Heart Health Program, Director Preventive Cardiac Center, Cedars-Sinai, Los Angeles, USA

    C. Noel Bairey Merz

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing AG

About this chapter

Cite this chapter

Maas, A.H.E.M., Bairey Merz, C.N. (2017). Ischemic Heart Disease in Women. In: Maas, A., Bairey Merz, C. (eds) Manual of Gynecardiology. Springer, Cham. https://doi.org/10.1007/978-3-319-54960-6_2

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-54960-6_2

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-54959-0

  • Online ISBN: 978-3-319-54960-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation