Faculty of Medicine

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Author: search.filters.author.Bugiardini, RaffaeleSubject: search.filters.subject.Sex differences

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    Sex and gender differences in coronary pathophysiology and ischaemic heart disease
    (Oxford University Press (OUP), 2026-01-23)
    Manfrini, Olivia
    ;
    Tousoulis, Dimitris
    ;
    Antoniades, Charalambos
    ;
    Badimon, Lina
    ;
    Bugiardini, Raffaele
    Ischaemic heart disease shows important differences between men and women, requiring an understanding of sex and gender dissimilarities to improve outcomes. This Scientific Statement provides an updated review of the current knowledge from risk factors to prognosis. It discusses the unequal impact of certain traditional risk factors between men and women, along with additional factors, such as hormonal changes and treatments (including those for transgender people and cancer), pregnancy-related complications, and autoimmune diseases, which contribute to the sex-specific risk profiles. Moreover, it outlines functional and structural sex differences in the pathophysiology (e.g. coronary atheroma plaques and burden, coronary dissection, vasospasm, and microvascular disease) with women being more prone to microvascular disease and endothelial dysfunction, while paradoxically experiencing less severe myocardial ischaemia at similar levels of coronary stenosis. The document further addresses the evaluation of diagnostic tools, which often have a male-centric bias, resulting in underdiagnosis in women who also tend to receive less guideline-recommended treatment. Additionally, women can have different responses and side effects to various preventive and therapeutic treatments, potentially contributing to the worse prognosis documented in acute coronary syndromes with obstructive coronary artery disease, particularly at a young age. Considering all these sex and gender differences and the low enrolment of women in randomized controlled trials, questions arise regarding the optimal treatment for women. Addressing sex differences requires conducting sex-specific research to close the knowledge gap. Overall, the Scientific Statement highlights all relevant sex- and gender-specific dissimilarities to advance clinical practice and identify directions for future research to improve guideline recommendations for equitable care.
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    Coronary revascularization and sex differences in cardiovascular mortality after myocardial infarction in 12 high and middle-income European countries
    (Oxford University Press (OUP), 2024-05-07)
    Cenko, Edina
    ;
    Yoon, Jinsung
    ;
    Bergami, Maria
    ;
    Gale, Chris P
    ;
    Vasiljevic, Zorana
    Existing data on female sex and excess cardiovascular mortality after myocardial infarction (MI) mostly come from high-income countries (HICs). This study aimed to investigate how sex disparities in treatments and outcomes vary across countries with different income levels.
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    Coronary revascularization and sex differences in cardiovascular mortality after myocardial infarction in 12 high and middle-income European countries
    (Oxford University Press (OUP), 2024-05)
    Cenko, Edina
    ;
    Yoon, Jinsung
    ;
    Bergami, Maria
    ;
    Gale, Chris P
    ;
    Vasiljevic, Zorana
    Existing data on female sex and excess cardiovascular mortality after myocardial infarction (MI) mostly come from high-income countries (HICs). This study aimed to investigate how sex disparities in treatments and outcomes vary across countries with different income levels.
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    Traditional risk factors and premature acute coronary syndromes in South Eastern Europe: a multinational cohort study
    (Elsevier BV, 2024-03)
    Bugiardini, Raffaele
    ;
    Cenko, Edina
    ;
    Yoon, Jinsung
    ;
    Bergami, Maria
    ;
    Vasiljevic, Zorana
    The age-standardized death rates under 65 years from ischemic heart disease in South Eastern Europe are approximately twice as high than the Western Europe average, but the reasons are not completely recognized. The aim of the present study was to address this issue by collecting and analyzing data from a large, multinational cohort.