Chambers Terry Ann, Bagai Aisha, Ivascu Natalia
Department of Anesthesiology, Weill Medical College of Cornell University New York, NY 10021, USA.
Curr Opin Anaesthesiol. 2007 Feb;20(1):75-82. doi: 10.1097/ACO.0b013e3280146455.
There are some striking sex differences regarding presentation, symptoms and sign, diagnosis, and treatment of coronary artery disease. Historically, healthcare delivery to women has been plagued with treatment bias favoring men. This review will present relevant cardiovascular physiologic sex differences, current treatment options for coronary artery disease both surgical and medical, and clinical outcomes of such treatments.
In the past, pharmacologic and interventional studies generally excluded women from their subjects. As a result, women have been traditionally treated based on the findings in their male counterparts. Recent studies examining sex differences in the treatment of coronary artery disease have given new insight into the hormonal and behavioral influences associated with coronary artery disease. Finally, these studies have drawn attention to possibly inadvertent discrepancies in the way men and women are treated for coronary artery disease.
Despite significant advances in medical and surgical approaches to treat coronary artery disease, it remains and will continue to be the most important healthcare challenge of the 21st century. Whereas efforts are underway to encourage inclusion of more women in therapeutic trials, the educational process, particularly in medical school, needs to broadly address sex specific pathophysiology and treatment, rather than relying on sub-subspecialty training for optimizing healthcare delivery in women.
在冠状动脉疾病的表现、症状体征、诊断及治疗方面存在一些显著的性别差异。从历史上看，针对女性的医疗服务一直受到偏向男性的治疗偏见的困扰。本综述将阐述相关的心血管生理性别差异、目前针对冠状动脉疾病的手术和药物治疗选择以及这些治疗的临床结果。
过去，药理学和介入研究通常将女性排除在研究对象之外。因此，传统上女性一直是根据男性研究结果进行治疗。最近关于冠状动脉疾病治疗中性别差异的研究为与冠状动脉疾病相关的激素和行为影响提供了新的见解。最后，这些研究引起了人们对男性和女性在冠状动脉疾病治疗方式上可能存在的意外差异的关注。
尽管在治疗冠状动脉疾病的医学和外科方法上取得了重大进展，但它仍然是并将继续是21世纪最重要的医疗挑战。虽然正在努力鼓励更多女性参与治疗试验，但教育过程，尤其是在医学院，需要广泛涉及特定性别的病理生理学和治疗方法，而不是依赖亚专业培训来优化针对女性的医疗服务。
