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Sex-Specific Differences in Acute Myocardial Infarction

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Abstract

Ischemic heart disease remains the leading cause of death in the United States for both men and women. Since the 1980s medical advancements in prevention and management of ischemic heart disease have dramatically reduced morbidity and mortality. Unfortunately improvements in care have not affected men and women equitably and there remain significant disparities in outcomes post acute myocardial infarction (AMI) when gender is considered. Women have worse outcomes from AMI as compared to men, with younger women experiencing comparatively higher mortality rates. As our knowledge of cardiovascular health continues to develop, we have come to recognize that there are gender differences in AMI presentation, pathophysiology and eventual management. The basis for this can be attributed to both biological differences in pathophysiological mechanisms and also to unequal delivery of care. Women with AMI remain under-recognized and under-treated by the current health care system, despite increasing awareness and advancement in women’s cardiovascular health. This chapter will discuss known and emerging gender differences in pathophysiology, risk factors, clinical presentation, diagnosis, and management of AMI, with aim to educate healthcare providers about ongoing significant disparities. Additional efforts and research are imperative to improving outcomes for women with AMI.

Keywords

  • Myocardial infarction
  • Ischemic heart disease
  • Women’s heart disease

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Acknowledgment

This work was supported by NIH-NHLBI grant K23HL105787 and the Emory Clinical Cardiovascular Research Institute (ECCRI).

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Correspondence to Puja K. Mehta M.D., F.A.C.C., F.A.H.A. .

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Young, A.LN., Mehta, P.K., Herbst, A., Ahmed, B. (2018). Sex-Specific Differences in Acute Myocardial Infarction. In: Mehta, J., McSweeney, J. (eds) Gender Differences in the Pathogenesis and Management of Heart Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-71135-5_11

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