Department of Medicine, Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, TN, USA.
Curr Cardiol Rep. 2024 May;26(5):293-301. doi: 10.1007/s11886-024-02033-6. Epub 2024 Mar 11.
The goal of this manuscript is to provide a concise summary of recent developments in the approach to and treatment of women with acute coronary syndrome (ACS).
This review covers terminology updates relating to ACS and myocardial injury and infarction. Updates on disparities in recognition, treatments, and outcomes of women with ACS due to atherosclerotic coronary artery disease are covered. Other causes of ACS, including spontaneous coronary artery dissection and myocardial infarction with non-obstructive coronary artery disease are discussed, given the increased frequency in women compared with men. The review summarizes the latest on the unique circumstance of ACS in women who are pregnant or post-partum, including etiologies, diagnostic approaches, medication safety, and revascularization considerations. Compared with men, women with ACS have unique risk factors, presentations, and pathophysiology. Treatments known to be effective for men with atherosclerosis-related ACS are also effective for women; further work remains on reducing the disparities in diagnosis and treatment. Implementation of multimodality imaging will improve diagnostic accuracy and allow for targeted medical therapy in the setting of myocardial infarction with non-obstructive coronary artery disease.
本文旨在对女性急性冠状动脉综合征（ACS）的治疗方法进行简要综述。
本文涵盖了与 ACS 和心肌损伤及梗死相关的术语更新。讨论了由于动脉粥样硬化性冠状动脉疾病导致女性 ACS 的识别、治疗和结局方面的差异。鉴于女性 ACS 的发生率高于男性，包括自发性冠状动脉夹层和非阻塞性冠状动脉疾病相关心肌梗死等其他 ACS 病因也有所涉及。本文还总结了 ACS 最新的特殊情况，包括女性在怀孕或产后时的 ACS 的病因、诊断方法、药物安全性和血运重建的考虑因素。与男性相比，女性 ACS 具有独特的危险因素、表现和病理生理学。已知对动脉粥样硬化相关 ACS 男性有效的治疗方法对女性同样有效；在减少诊断和治疗差异方面仍有进一步的工作要做。多模态影像学的应用将提高诊断的准确性，并允许在非阻塞性冠状动脉疾病相关心肌梗死的情况下进行靶向药物治疗。
