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Gender disparities in coronary artery disease: a review of factors influencing clinical outcomes

Arsalan Siddiqui,Randeep Gill,Marc Ringor,J. Dugal,Arpinder S. Malhi,Ala W. Abdallah,Dalia Hawwass,Nazanin Houshmand,Tahir Tak

Published 2025 in Netherlands Heart Journal

ABSTRACT

Coronary artery disease (CAD) is a leading cause of morbidity and mortality worldwide, affecting both women and men. However, its evaluation and treatment have historically been influenced by gender, resulting in significant disparities for women. This review aims to comprehensively examine the literature on gender disparities in the care of patients with CAD. Evidence highlights several key inequalities, including the relatively greater impact of shared risk factors in women, the presence of female-specific risk factors, differences in CAD symptom presentation, and reduced screening sensitivity and management quality in women compared with men. Addressing these disparities requires updated screening strategies that recognize the unique clinical manifestations of CAD in women, increasing awareness among both women and healthcare providers, greater inclusion of women in CAD research studies, revisiting the role of hormonal replacement therapy, and integrating emerging tools such as genetic research and artificial intelligence. These steps have the potential to improve the equity and effectiveness of CAD management across genders.

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