| Abstract [eng] |
Acute Coronary Syndrome (ACS) remains a leading cause of global morbidity and mortality, with growing evidence highlighting significant sex- and gender-related disparities in its presentation, diagnosis, management, and outcomes. Although cardiovascular care has improved over the past years, women continue to be under-recognized and undertreated, underscoring the need for gender-sensitive research. This study aims to systematically analyze and synthesize current evidence on gender differences in ACS, focusing on clinical presentation, diagnostic challenges, treatment strategies, and outcomes. The objectives include identifying key sex-based differences, evaluating contributing factors, and assessing their impact on prognosis. A narrative literature review was conducted using databases such as PubMed, Google Scholar, and the Cochrane Library, alongside international clinical guidelines. Studies published between 1990 and 2026 were included, covering various designs such as randomized controlled trials, observational studies, and meta-analyses. Data were thematically analyzed to address the research questions. The findings reveal that women with ACS often present with differing symptom patterns, experience diagnostic delays, and are less likely to receive timely and guideline-recommended therapies, including reperfusion and pharmacological treatment. Additionally, women exhibit higher unadjusted mortality rates, largely influenced by older age at presentation, comorbidities, and systemic healthcare disparities. Younger women, in particular, demonstrate worse outcomes compared to men of the same age group. In conclusion, significant gender disparities persist across all stages of ACS care. Addressing these differences requires improved awareness of sex-specific manifestations, equitable implementation of clinical guidelines, and increased representation of women in clinical research. Targeted interventions are essential to optimize outcomes and ensure more personalized, gender-sensitive cardiovascular care. |
