Sex-Related Outcomes of Medical, Percutaneous, and Surgical Interventions for Coronary Artery Disease

Biological and sociocultural differences between men and women are complex and likely account for most of the variations in the epidemiology and treatment outcomes of coronary artery disease (CAD) between the 2 sexes. Worse outcomes in women have been described following both conservative and invasive treatments of CAD. For example, increased levels of residual platelet reactivity during treatment with antiplatelet drugs, higher rates of adverse cardiovascular outcomes following percutaneous coronary revascularization, and higher operative and long-term mortality after coronary bypass surgery have been reported in women compared with in men. Despite the growing recognition of sex-specific determinants of outcomes, representation of women in clinical studies remains low and sex-specific management strategies are generally not provided in guidelines. This review summarizes the current evidence on sex-related differences in patients with CAD, focusing on the differential outcomes following medical therapy, percutaneous coronary interventions, and coronary artery bypass surgery. • Women undergoing medical and invasive treatments for CAD generally have worse outcomes than men do. • Sex-related differences in treatment outcomes among patients with CAD involve interactions among biological, social, and cultural factors. • Further research is needed to improve the application and outcomes of treatment for women with CAD.