Titterington Jane S, Hung Olivia Y, Saraf Anita P, Wenger Nanette K
a Department of Medicine, Division of Cardiology , Emory University School of Medicine , Atlanta , GA , USA.
Expert Rev Cardiovasc Ther. 2018 Apr;16(4):297-304. doi: 10.1080/14779072.2018.1443808. Epub 2018 Mar 7.
The etiologies of acute coronary syndromes (ACS) in women expand beyond the traditional paradigm of obstructive epicardial atherosclerotic disease and plaque rupture. Fundamental differences in pathobiology and presentation can partially explain the gender disparity in ACS diagnosis and management, but there is also much we do not know about the spectrum of coronary artery disease in women. Areas covered: This review seeks to explain some key differences between men and women in terms of risk factors, pathophysiology, and clinical presentations, as well as identify areas where more data are needed, focusing on women presenting with ACS but without a culprit lesion to explain their presentation. Literature search was undertaken with PubMed and Google Scholar. Expert commentary: Women with acute coronary syndromes but without plaque rupture or obstructive epicardial atherosclerosis can be difficult to diagnose and manage. Improving care in this underdiagnosed and undertreated population will require early identification of at risk patients, development of better diagnostic strategies, and standardized implementation of guideline-based therapies.
女性急性冠状动脉综合征（ACS）的病因超出了传统的阻塞性心外膜动脉粥样硬化疾病和斑块破裂范式。病理生物学和临床表现的根本差异可以部分解释ACS诊断和管理中的性别差异，但我们对女性冠状动脉疾病的范围仍知之甚少。涵盖领域：本综述旨在解释男性和女性在危险因素、病理生理学和临床表现方面的一些关键差异，并确定需要更多数据的领域，重点关注表现为ACS但无罪犯病变来解释其临床表现的女性。通过PubMed和谷歌学术进行了文献检索。专家评论：患有急性冠状动脉综合征但无斑块破裂或阻塞性心外膜动脉粥样硬化的女性可能难以诊断和管理。改善对这一诊断不足和治疗不足人群的护理将需要早期识别高危患者、制定更好的诊断策略以及基于指南的治疗的标准化实施。
