Women, ischemic heart disease, revascularization, and the gender gap: what are we missing?

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.