Acute Coronary Syndromes: Differences in Men and Women

  • Kris R. Kawamoto
  • Melinda B. Davis
  • Claire S. Duvernoy
Women and Ischemic Heart Disease (E. Jackson, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Women and Ischemic Heart Disease


Purpose of Review

Increased awareness of cardiovascular disease in women has prompted studies to investigate gender-related disparities in acute coronary syndromes (ACSs). In this review, we discuss findings from current literature on the clinical presentation, pathophysiology, diagnosis, and management of ACS in women as compared to men.

Recent Findings

Emerging data show that cardiovascular disease (CVD) continues to be the leading cause of death in women and the annual mortality rate from CVD remains higher in women compared to men. Recent studies demonstrate sex-specific differences in patients presenting with ACS. Comorbidities, especially diabetes, are more common in young women compared with age-matched men who develop acute myocardial infarction (AMI). Women are more likely to have atypical symptoms and nonobstructive coronary disease on angiography. Women are less likely to receive guideline-based therapies. They have higher rates of peri-procedural complications with PCI and are less likely to be referred to cardiac rehabilitation.


Awareness of differences in the underlying pathophysiology of coronary disease in women compared to men may lead to improved gender-based diagnostic and treatment modalities. However, until more studies are performed, efforts should be directed toward improving delivery of current, gender-neutral guidelines in women just as in men.


Acute coronary syndrome Women Nonobstructive coronary disease Gender differences Myocardial infarction 


Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media New York (outside the USA) 2016

Authors and Affiliations

  • Kris R. Kawamoto
    • 1
    • 2
  • Melinda B. Davis
    • 1
    • 2
  • Claire S. Duvernoy
    • 1
    • 2
  1. 1.Division of Cardiovascular Medicine, Department of Internal MedicineUniversity of MichiganAnn ArborUSA
  2. 2.Cardiology Section, Medical ServiceVA Ann Arbor Healthcare SystemAnn ArborUSA

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