urmjУральский медицинский журналUral Medical Journal2949-4389Ural State Medical University10.52420/2071-5943-2023-22-4-128-139urmj-1300Research ArticleЛитературные обзоры | Literature reviewsLiterature reviewsОстрый коронарный синдром у женщин. Есть ли особенности?Acute coronary syndrome in women. Are there any special features?https://orcid.org/0000-0002-2847-4422БродовскаяТ. О.BrodovskayaT. O.

Татьяна Олеговна Бродовская, доктор медицинских наук, доцент, доцент кафедры поликлинической терапии, ультразвуковой и функциональной диагностики,

Екатеринбург

Doctor of Science (Medicine), Associate Professor, Department of Outpatient Therapy,  Ultrasound and Functional Diagnostics, 

Ekaterinburg

tbrod80@gmail.comhttps://orcid.org/0000-0002-1844-9039АребьевЭ. В.ArebevE. V.

Эдуард Васильевич Аребьев, врач врачебного здравпункта аэровокзального комплекса,

Екатеринбург

Physician at the health centre of the air terminal complex, 

Ekaterinburg

earebyev@gmail.comhttps://orcid.org/0000-0002-9004-3711ГришинаИ. Ф.GrishinaI. F.

Ирина Федоровна Гришина, доктор медицинских наук, профессор, заведующая кафедрой поликлинической терапии, ультразвуковой и функциональной диагностики, 

Екатеринбург

Doctor of Science (Medicine), Professor, Head of the Department of Outpatient Therapy, Ultrasound and Functional Diagnostics,

Ekaterinburg

grishina@edc.nexcom.ruhttps://orcid.org/0000-0003-4621-7865ПетровскихМ. И.PetrovskikhM. I.

Мария Ивановна Петровских, студентка, 

Екатеринбург

Student, 

Ekaterinburg

maria.petrovskih@yandex.ruУральский государственный медицинский университетРоссияUral State Medical UniversityRussian FederationАэропорт КольцовоРоссияKoltsovo AirportRussian Federation202313082023224128139Copyright © Бродовская Т.О., Аребьев Э.В., Гришина И.Ф., Петровских М.И., 20232023Бродовская Т.О., Аребьев Э.В., Гришина И.Ф., Петровских М.И.Brodovskaya T.O., Arebev E.V., Grishina I.F., Petrovskikh M.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.umjusmu.ru/jour/article/view/1300Введение

Введение. Возрастающая заболеваемость ишемической болезнью сердца, в том числе острым коронарным синдромом, среди женщин, недостаточная осведомленность населения о кардиоваскулярных рисках у женщин и позднее обращение за медицинской помощью данной категории пациентов определяют необходимость обзора существующей литературы по указанной проблеме.

Цель работы − систематизация данных об остром коронарном синдроме у женщин и характеристика его отличительных особенностей.

Материалы и методы

Материалы и методы. Поиск литературных источников был проведен за период 2011−2022 годы в базах данных PubMed, Cochrane Library, Embase, Google Scholar с помощью поисковых словосочетаний: сердечно-сосудистые заболевания (cardiovascular diseases in women), ишемическая болезнь сердца (ischemic heart disease in women), острый коронарнй синдром (acute coronary syndrome in women) и инфаркт миокарда (acute myocardial infacrtion in women) у женщин. Критерии включения: данные о половых различиях в структуре острого коронарного синдрома. Предпочтительными языками были русский и английский.

Результаты и обсуждение

Результаты и обсуждение. Охарактеризованы факторы риска острого коронарного синдрома у женщин, обобщены данные об особенностях клиники данной патологии. Представлены сведения о проблеме дифференцированного подхода и об определении тактики ведения пациенток с острым коронарным синдромом.

Заключение

Заключение. Несмотря на повышающуюся осведомленность о сердечно-сосудистых заболеваниях, как основной причины инвалидизации и смертности среди обоих полов, внимание специалистов к проблеме дифференцированного подхода к ведению женщин с ОКС остается недостаточным, что определяет необходимость углубленного изучения данной проблемы.

Introduction

Introduction. The increasing incidence of coronary heart disease, including acute coronary syndrome, among women, the lack of public awareness of the cardiovascular risks in women and the late presentation of these patients for medical care necessitates a review of the existing literature on the problem.

Purpose of the work was to systematize data on acute coronary syndrome in women and to characterize its distinctive features.

Materials and methods

Materials and methods. A literature search was conducted for the period from 2011 to 2022 in PubMed, Cochrane Library, Embase, Google Scholar using the search terms: cardiovascular diseases in women, ischemic heart disease in women, acute coronary syndrome in women and acute myocardial infarction in women. Inclusion criteria: evidence of sex differences in acute coronary syndrome. The preferred languages were Russian and English.

Results and discussion

Results and discussion. The risk factors of acute coronary syndrome in women are characterized and the data on the peculiarities of the clinic of this pathology are summarized. Data on the problem of a differentiated approach and on the determination of management tactics for patients with acute coronary syndrome are presented.

Conclusion

Conclusion. Despite the increasing awareness of cardiovascular disease as a major cause of disability and mortality in both sexes, the attention of specialists to the problem of a differentiated approach to the management of women with ACS remains insufficient, which determines the need for in-depth research on this problem.

сердечно-сосудистые заболеванияишемическая болезнь сердцаострый коронарный синдроминфаркт миокардаженщиныcardiovascular diseasesischemic heart diseaseacute coronary syndromeacute myocardial infarctionReferencesTsao CW, Aday AW, Almarzooq ZI et al. Heart disease and stroke statistics—2022 update: a report from the American Heart Association. Circulation. 2022;145(8):e153−e639. https://doi.org/10.1161/cir.0000000000001052.Tsao CW, Aday AW, Almarzooq ZI et al. Heart disease and stroke statistics—2022 update: a report from the American Heart Association. Circulation. 2022;145(8):e153−e639. https://doi.org/10.1161/cir.0000000000001052.Андреенко Е.Ю., Явелов И.С., Лукьянов М.М. с соавт. Ишемическая болезнь сердца у лиц молодого возраста: распространенность и сердечно-сосудистые факторы риска. Кардиология. 2018;58(10):53−58. https://doi.org/10.18087/cardio.2018.10.10184.Andreenko EY, Yavelov IS, Loukianov MM et al. Ischemic heart disease in subjects of young age: current state of the problem. prevalence and cardio-vascular risk factors. Cardiology. 2018;58(10):53−58. (In Russ.). https://doi.org/10.18087/cardio.2018.10.10184.Cushman M, Shay CM, Howard VJ et al. Ten-year differences in women’s awareness related to coronary heart disease: results of the 2019 American Heart Association National Survey: a special report from the American Heart Association. Circulation. 2021;143(7):e239−e248. https://doi.org/10.1161/cir.0000000000000907.Cushman M, Shay CM, Howard VJ et al. Ten-year differences in women’s awareness related to coronary heart disease: results of the 2019 American Heart Association National Survey: a special report from the American Heart Association. Circulation. 2021;143(7):e239−e248. https://doi.org/10.1161/cir.0000000000000907.Regitz-Zagrosek V, Oertelt-Prigione S, Prescott E et al. Gender in cardiovascular diseases: impact on clinical manifestations, management, and outcomes. Eur Heart J. 2015;37(1):24–34. https://doi.org/10.1093/eurheartj/ehv598.Regitz-Zagrosek V, Oertelt-Prigione S, Prescott E et al. Gender in cardiovascular diseases: impact on clinical manifestations, management, and outcomes. Eur Heart J. 2015;37(1):24–34. https://doi.org/10.1093/eurheartj/ehv598.Achenbach S. Coronary calcium: ‘bad news’ for men, but even ‘worse news’ for women? Eur Heart J. 2018;39(41):3736– 3738. https://doi.org/10.1093/eurheartj/ehy630.Achenbach S. Coronary calcium: ‘bad news’ for men, but even ‘worse news’ for women? Eur Heart J. 2018;39(41):3736– 3738. https://doi.org/10.1093/eurheartj/ehy630.Gabet A, Danchin N, Juillière Y et al. Acute coronary syndrome in women: rising hospitalizations in middle-aged French women, 2004–14. Eur Heart J. 2017;38(14):1060–1065. https://doi.org/10.1093/eurheartj/ehx097.Gabet A, Danchin N, Juillière Y et al. Acute coronary syndrome in women: rising hospitalizations in middle-aged French women, 2004–14. Eur Heart J. 2017;38(14):1060–1065. https://doi.org/10.1093/eurheartj/ehx097.Puymirat E. Association of changes in clinical characteristics and management with improvement in survival among patients with st-elevation myocardial infarction. JAMA. 2012;308(10):998. https://doi.org/10.1001/2012.jama.11348.Puymirat E. Association of changes in clinical characteristics and management with improvement in survival among patients with st-elevation myocardial infarction. JAMA. 2012;308(10):998. https://doi.org/10.1001/2012.jama.11348.Arora S, Stouffer GA, Kucharska-Newton AM et al. Twenty year trends and sex differences in young adults hospitalized with acute myocardial infarction. Circulation. 2019;139(8):1047–1056. https://doi.org/10.1161/circulationaha.118.037137.Arora S, Stouffer GA, Kucharska-Newton AM et al. Twenty year trends and sex differences in young adults hospitalized with acute myocardial infarction. Circulation. 2019;139(8):1047–1056. https://doi.org/10.1161/circulationaha.118.037137.Banco D, Chang J, Talmor N et al. Sex and race differences in the evaluation and treatment of young adults presenting to the emergency department with chest pain. J Am Heart Assoc. 2022;11(10):e024199. https://doi.org/10.1161/jaha.121.024199.Banco D, Chang J, Talmor N et al. Sex and race differences in the evaluation and treatment of young adults presenting to the emergency department with chest pain. J Am Heart Assoc. 2022;11(10):e024199. https://doi.org/10.1161/jaha.121.024199.Haider A, Bengs S, Luu J et al. Sex and gender in cardiovascular medicine: presentation and outcomes of acute coronary syndrome. Eur Heart J. 2019;41(13):1328–1336. https://doi.org/10.1093/eurheartj/ehz898.Haider A, Bengs S, Luu J et al. Sex and gender in cardiovascular medicine: presentation and outcomes of acute coronary syndrome. Eur Heart J. 2019;41(13):1328–1336. https://doi.org/10.1093/eurheartj/ehz898.Hellgren T, Blöndal M, Jortveit J et al. Sex-related differences in the management and outcomes of patients hospitalized with ST-elevation myocardial infarction: a comparison within four European myocardial infarction registries. Eur Heart J Open. 2022;2(4). https://doi.org/10.1093/ehjopen/oeac042.Hellgren T, Blöndal M, Jortveit J et al. Sex-related differences in the management and outcomes of patients hospitalized with ST-elevation myocardial infarction: a comparison within four European myocardial infarction registries. Eur Heart J Open. 2022;2(4). https://doi.org/10.1093/ehjopen/oeac042.Fairbairn TA, Dobson R, Hurwitz-Koweek L et al. Sex differences in coronary computed tomography angiography-derived fractional flow reserve: lessons from ADVANCE. JACC: Cardiovasc Imaging. 2020;13(12):2576–2587. https://doi.org/10.1016/j.jcmg.2020.07.008.Fairbairn TA, Dobson R, Hurwitz-Koweek L et al. Sex differences in coronary computed tomography angiography– derived fractional flow reserve: lessons from ADVANCE. JACC: Cardiovasc Imaging. 2020;13(12):2576–2587. https://doi.org/10.1016/j.jcmg.2020.07.008.Hemal K, Pagidipati NJ, Coles A et al. Sex differences in demographics, risk factors, presentation, and noninvasive testing in stable outpatients with suspected coronary artery disease. JACC: Cardiovasc Imaging. 2016;9(4):337–346. https://doi.org/10.1016/j.jcmg.2016.02.001.Hemal K, Pagidipati NJ, Coles A et al. Sex differences in demographics, risk factors, presentation, and noninvasive testing in stable outpatients with suspected coronary artery disease. JACC: Cardiovasc Imaging. 2016;9(4):337–346. https://doi.org/10.1016/j.jcmg.2016.02.001.Van Den Hoogen IJ, Gianni U, Bax AM et al. Sex-specific risk for ischemia by invasive fractional flow reserve according to coronary atherosclerotic features: results from the CREDENCE trial. Eur Heart J. 2020;41(Supplement_2): ehaa946.0188. https://doi.org/10.1093/ehjci/ehaa946.0188.Van Den Hoogen IJ, Gianni U, Bax AM et al. Sex-specific risk for ischemia by invasive fractional flow reserve according to coronary atherosclerotic features: results from the CREDENCE trial. Eur Heart J. 2020;41(Supplement_2): ehaa946.0188. https://doi.org/10.1093/ehjci/ehaa946.0188.Guo W, Du X, Gao Y et al. Sex differences in characteristics, treatments, and outcomes among patients hospitalized for non–st-segment–elevation myocardial infarction in China: 2006 to 2015. Circ Cardiovasc Qual Outcomes. 2022;15(6):e008535. https://doi.org/10.1161/circoutcomes.121.008535.Guo W, Du X, Gao Y et al. Sex differences in characteristics, treatments, and outcomes among patients hospitalized for non–st-segment–elevation myocardial infarction in China: 2006 to 2015. Circ Cardiovasc Qual Outcomes. 2022;15(6):e008535. https://doi.org/10.1161/circoutcomes.121.008535.Kuehnemund L, Koeppe J, Feld J et al. Gender differences in acute myocardial infarction − A nationwide German real-life analysis from 2014 to 2017. Clin Cardiol. 2021;44(7):890–898. https://doi.org/10.1002/clc.23662.Kuehnemund L, Koeppe J, Feld J et al. Gender differences in acute myocardial infarction − A nationwide German real-life analysis from 2014 to 2017. Clin Cardiol. 2021;44(7):890–898. https://doi.org/10.1002/clc.23662.Lee CY, Liu KT, Lu HT et al. Sex and gender differences in presentation, treatment and outcomes in acute coronary syndrome, a 10 year study from a multi-ethnic Asian population: The Malaysian National Cardiovascular Disease Database − Acute Coronary Syndrome (NCVD-ACS) registry. PLoS ONE. 2021;16(2):e0246474. https://doi.org/10.1371/journal.pone.0246474.Lee CY, Liu KT, Lu HT et al. Sex and gender differences in presentation, treatment and outcomes in acute coronary syndrome, a 10 year study from a multi-ethnic Asian population: The Malaysian National Cardiovascular Disease Database − Acute Coronary Syndrome (NCVD-ACS) registry. PLoS ONE. 2021;16(2):e0246474. https://doi.org/10.1371/journal.pone.0246474.Elgendy IY, Wegermann ZK, Li S et al. Sex differences in management and outcomes of acute myocardial infarction patients presenting with cardiogenic shock. JACC: Cardiovasc Interv. 2022;15(6):642–652. https://doi.org/10.1016/j.jcin.2021.12.033.Elgendy IY, Wegermann ZK, Li S et al. Sex differences in management and outcomes of acute myocardial infarction patients presenting with cardiogenic shock. JACC: Cardiovasc Interv. 2022;15(6):642–652. https://doi.org/10.1016/j.jcin.2021.12.033.Asleh R, Manemann SM, Weston SA et al. Sex differences in outcomes after myocardial infarction in the community. Am J Med. 2021;134(1):114–121. https://doi.org/10.1016/j.amjmed.2020.05.040.Asleh R, Manemann SM, Weston SA et al. Sex differences in outcomes after myocardial infarction in the community. Am J Med. 2021;134(1):114–121. https://doi.org/10.1016/j.amjmed.2020.05.040.Ruiz-Nodar JM, Ferreiro JL, Ribera A et al. Sex differences in the management of patients with acute coronary syndrome: A population-based ecological cross-sectional study in Spain. REC: CardioClinics. 2021;56(3):168–178. https://doi.org/10.1016/j.rccl.2020.10.009.Ruiz-Nodar JM, Ferreiro JL, Ribera A et al. Sex differences in the management of patients with acute coronary syndrome: A population-based ecological cross-sectional study in Spain. REC: CardioClinics. 2021;56(3):168–178. https://doi.org/10.1016/j.rccl.2020.10.009.Ten Haaf ME, Bax M, ten Berg JM et al. Sex differences in characteristics and outcome in acute coronary syndrome patients in the Netherlands. Neth Heart J. 2019;27(5):263–271. https://doi.org/10.1007/s12471-019-1271-0.Ten Haaf ME, Bax M, ten Berg JM et al. Sex differences in characteristics and outcome in acute coronary syndrome patients in the Netherlands. Neth Heart J. 2019;27(5):263–271. https://doi.org/10.1007/s12471-019-1271-0.Matetic A, Shamkhani W, Rashid M et al. Trends of sex differences in clinical outcomes after myocardial infarction in the United States. CJC Open. 2021;3(12):S19–27. https://doi.org/10.1016/j.cjco.2021.06.012.Matetic A, Shamkhani W, Rashid M et al. Trends of sex differences in clinical outcomes after myocardial infarction in the United States. CJC Open. 2021;3(12):S19–27. https://doi.org/10.1016/j.cjco.2021.06.012.Lin DS-H, Lin Y-S, Lee J-K et al. Sex differences following percutaneous coronary intervention or coronary artery bypass surgery for acute myocardial infarction. Biol Sex Differ. 2022;13(1):18. https://doi.org/10.1186/s13293-022-00427-1.Lin DS-H, Lin Y-S, Lee J-K et al. Sex differences following percutaneous coronary intervention or coronary artery bypass surgery for acute myocardial infarction. Biol Sex Differ. 2022;13(1):18. https://doi.org/10.1186/s13293-022-00427-1.Сумин А.Н., Корок Е.В., Щеглова А.В., Барбараш О.Л. Коморбидность у больных с ишемической болезнью сердца: гендерные особенности. Рациональная фармакотерапия в кардиологии. 2017;13(5):622−629. https://doi.org/10.20996/1819-6446-2017-13-5-622-629.Sumin AN, Korok EV, Shcheglova AV, Barbarash OL. Comorbidities in pateints with ischemic heart disease: gender differences. Rational Pharmacotherapy in Cardiology = Racional’naja farmakoterapija v kardiologii. 2017;13(5):622−629. (In Russ.). https://doi.org/10.20996/1819-6446-2017-13-5-622-629.Sumin AN, Korok EV, Shcheglova AV, Barbarash OL. Comorbidities in pateints with ischemic heart disease: gender differences. Rational Pharmacotherapy in Cardiology = Racional’naja farmakoterapija v kardiologii. 2017;13(5):622−629. (In Russ.). https://doi.org/10.20996/1819-6446-2017-13-5-622-629.Muromtseva GA, Kontsevaya AV, Konstantinov VV et al The prevalence of non-infectious diseases risk factors in Russian population in 2012-2013 years. The results of JeSSE-RF. Cardiovascular Therapy and Prevention = Kardiovaskuljarnaja terapija i profilaktika. 2014;13(6):4−11. (In Russ.). https://doi.org/10.15829/1728-8800-2014-6-4-11.Муромцева Г.А., Концевая А.В., Константинов В.В. с соавт. Распространенность факторов риска неинфекционных заболеваний в российской популяции в 2012−2013 гг. Результаты исследования ЭССЕ-РФ. Кардиоваскулярная терапия и профилактика. 2014;13(6):4−11. https://doi.org/10.15829/1728-8800-2014-6-4-11.Visseren FLJ, Mach F, Smulders YM et al. 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice. Eur Heart J. 2021;42(34):3227–337. https://doi.org/10.1093/eurheartj/ehab484.Visseren FLJ, Mach F, Smulders YM et al. 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice. Eur Heart J. 2021;42(34):3227–337. https://doi.org/10.1093/eurheartj/ehab484.Kasumova FN, Faradzheva NA, Mamedova RN, Sultanova SS. Comparative characteristics of risk factors as predictors of coronary heart disease in women during an epidemiological and clinical examination. Cardiovascular Therapy and Prevention = Kardiovaskuljarnaja terapija i profilaktika. 2019;18(1):90−94. (In Russ.). https://doi.org/10.15829/1728-8800-2019-1-90-94.Касумова Ф.Н., Фараджева Н.А., Мамедова Р.Н., Султанова С.С. Сравнительная характеристика факторов риска как предикторов ишемической болезни сердца у женщин при эпидемиологическом и клиническом обследовании. Кардиоваскулярная терапия и профилактика. 2019;18(1):90−94. https://doi.org/10.15829/1728-8800-2019-1-90-94.Kerola AM, Palomäki A, Rautava P et al. Less revascularization in young women but impaired long-term outcomes in young men after myocardial infarction. Eur J Prev Cardiol. 2022;29(10):1437–1445. https://doi.org/10.1093/eurjpc/zwac049.Kerola AM, Palomäki A, Rautava P et al. Less revascularization in young women but impaired long-term outcomes in young men after myocardial infarction. Eur J Prev Cardiol. 2022;29(10):1437–1445. https://doi.org/10.1093/eurjpc/zwac049.Sagaydak OV, Oschepkova EV, Chazova IE. Seх differences in treatment of acute coronary syndrome patients. Data from federal registry of acute coronary syndrome 2016–2019. Тherapeutic archive = Terapevticheskij arhiv. 2022;94(7):797−802. (In Russ.). https://doi.org/10.26442/00403660.2022.07.201732.Сагайдак О.В., Ощепкова Е.В., Чазова И.Е. Гендерные различия в оказании медицинской помощи при остром коронарном синдроме. Анализ данных Федерального регистра острого коронарного синдрома за 2016–2019 гг. Терапевтический архив. 2022;94(7):797−802. https://doi.org/10.26442/00403660.2022.07.201732.Boytsov SA, Balanova YA, Shalnova SAet al. Arterial hypertension among individuals of 25-64 years old: prevalence, awareness, treatment and control. By the data from JeSSE. Cardiovascular Therapy and Prevention = Kardiovaskuljarnaja terapija i profilaktika. 2014;13(4):4−14. (In Russ.). https://doi.org/10.15829/1728-8800-2014-4-4-14.Бойцов С.А., Баланова Ю.А., Шальнова С.А. с соавт. Артериальная гипертония среди лиц 25-64 лет: распространенность, осведомленность, лечение и контроль. По материалам исследования ЭССЕ. Кардиоваскулярная терапия и профилактика. 2014;13(4):4−14. https://doi.org/10.15829/1728-8800-2014-4-4-14.Ragino YI, Kuzminykh NA, Shcherbakova LV et al. Prevalence of coronary heart disease (by epidemiological criteria) and its association with lipid and non-lipid risk factors in the Novosibirsk population of 25−45 years. Russian Journal of Cardiology = Rossijskij kardiologicheskij zhurnal. 2019;(6):78−84. (In Russ.). https://doi.org/10.15829/1560-4071-2019-6-78-84.Рагино Ю.И., Кузьминых Н.А., Щербакова Л.В. с соавт. Распространенность ишемической болезни сердца (по эпидемиологическим критериям) и ее ассоциации с липидными и нелипидными факторами риска в популяции 25−45 лет Новосибирска. Российский кардиологический журнал. 2019;(6):78−84. https://doi.org/10.15829/1560-4071-2019-6-78-84.Balanova YA, Shalnova SA, Kutsenko VA et al. Contribution of hypertension and other risk factors to survival and mortality in the Russian population. Cardiovascular Therapy and Prevention = Kardiovaskuljarnaja terapija i profilaktika. 2021;20(5):3003. (In Russ.). https://doi.org/10.15829/1728-8800-2021-3003.Баланова Ю.А., Шальнова С.А., Куценко В.А. с соавт. Вклад артериальной гипертонии и других факторов риска в выживаемость и смертность в российской популяции. Кардиоваскулярная терапия и профилактика. 2021;20(5):3003. https://doi.org/10.15829/1728-8800-2021-3003.Maksimov SA, Cygankova DP. Population risk of ischemic heart disease depending on the volume of alcohol consumption by the population (JeSSE-RF Study in the Kemerovo Region). Cardiology = Kardiologija. 2019;59(1):62−68. (In Russ.). https://doi.org/10.18087/cardio.2019.1.10217.Максимов С.А., Цыганкова Д.П. Популяционный риск развития ишемической болезни сердца в зависимости от объемов потребления алкоголя населением (исследование ЭССЕ-РФ в Кемеровской области). Кардиология. 2019;59(1):62−68. https://doi.org/10.18087/cardio.2019.1.10217.Ferry AV, Anand A, Strachan FE et al. Presenting symptoms in men and women diagnosed with myocardial infarction using sex-specific criteria. J Am Heart Assoc. 2019;8(17):e012307. https://doi.org/10.1161/jaha.119.012307.Ferry AV, Anand A, Strachan FE et al. Presenting symptoms in men and women diagnosed with myocardial infarction using sex-specific criteria. J Am Heart Assoc. 2019;8(17):e012307. https://doi.org/10.1161/jaha.119.012307.Van Oosterhout REM, de Boer AR, Maas AHEM et al. Sex differences in symptom presentation in acute coronary syndromes: a systematic review and meta-analysis. J Am Heart Assoc. 2020;9(9):e014733. https://doi.org/10.1161/jaha.119.014733.Van Oosterhout REM, de Boer AR, Maas AHEM et al. Sex differences in symptom presentation in acute coronary syndromes: a systematic review and meta-analysis. J Am Heart Assoc. 2020;9(9):e014733. https://doi.org/10.1161/jaha.119.014733.Lichtman JH, Leifheit EC, Safdar B et al. Sex differences in the presentation and perception of symptoms among young patients with myocardial infarction. Circulation. 2018;137(8):781–790. https://doi.org/10.1161/circulationaha.117.031650.Lichtman JH, Leifheit EC, Safdar B et al. Sex differences in the presentation and perception of symptoms among young patients with myocardial infarction. Circulation. 2018;137(8):781–790. https://doi.org/10.1161/circulationaha.117.031650.Daponte-Codina A, Knox EC, Mateo-Rodriguez I et al. Gender and social inequalities in awareness of coronary artery disease in European countries. Int J Environ Res Public Health. 2022;19(3):1388. https://doi.org/10.3390/ijerph19031388.Daponte-Codina A, Knox EC, Mateo-Rodriguez I et al. Gender and social inequalities in awareness of coronary artery disease in European countries. Int J Environ Res Public Health. 2022;19(3):1388. https://doi.org/10.3390/ijerph19031388.Shaw LJ, Min JK, Nasir K et al. Sex differences in calcified plaque and long-term cardiovascular mortality: observations from the CAC Consortium. Eur Heart J. 2018;39(41):3727–3735. https://doi.org/10.1093/eurheartj/ehy534.Shaw LJ, Min JK, Nasir K et al. Sex differences in calcified plaque and long-term cardiovascular mortality: observations from the CAC Consortium. Eur Heart J. 2018;39(41):3727–3735. https://doi.org/10.1093/eurheartj/ehy534.Lee S-E, Sung JM, Andreini D et al. Sex differences in compositional plaque volume progression in patients with coronary artery disease. JACC Cardiovasc Imaging. 2020;13(11):2386–2396. https://doi.org/10.1016/j.jcmg.2020.06.034.Lee S-E, Sung JM, Andreini D et al. Sex differences in compositional plaque volume progression in patients with coronary artery disease. JACC Cardiovasc Imaging. 2020;13(11):2386–2396. https://doi.org/10.1016/j.jcmg.2020.06.034.Bochkareva EV, Kim IV, Butina EK et al. Mammographic screening as a tool for cardiovascular risk assessing. part 2. association of breast arterial calcification and cardiovascular diseases. Rational Pharmacotherapy in Cardiology = Racional’naja farmakoterapija v kardiologii. 2019;15(3):424−430. (In Russ.). https://doi.org/10.20996/1819-6446-2019-15-3-424-430.Бочкарева Е.В., Ким И.В., Бутина Е.К. с соавт. Маммографический скрининг как инструмент оценки сердечно-сосудистого риска. Часть 2. Кальциноз артерий молочной железы − связь с сердечно-сосудистыми заболеваниями. Рациональ ная фармакотерапия в кардиологии. 2019;15(3):424−430. https://doi.org/10.20996/1819-6446-2019-15-3-424-430.Rodriguez Lozano PF, Rrapo Kaso E, Bourque JM et al. Cardiovascular imaging for ischemic heart disease in women. JACC Cardiovasc Imaging. 2022;15(8):1488–1501. https://doi.org/10.1016/j.jcmg.2022.01.006.Rodriguez Lozano PF, Rrapo Kaso E, Bourque JM et al. Cardiovascular imaging for ischemic heart disease in women. JACC Cardiovasc Imaging. 2022;15(8):1488–1501. https://doi.org/10.1016/j.jcmg.2022.01.006.Seegers LM, Araki M, Nakajima A et al. Sex differences in culprit plaque characteristics among different age groups in patients with acute coronary syndromes. Circ Cardiovasc Interv. 2022;15(6):e011612. https://doi.org/10.1161/circinterventions.121.011612.Seegers LM, Araki M, Nakajima A et al. Sex differences in culprit plaque characteristics among different age groups in patients with acute coronary syndromes. Circ Cardiovasc Interv. 2022;15(6):e011612. https://doi.org/10.1161/circinterventions.121.011612.Reynolds HR, Shaw LJ, Min JK et al. Association of sex with severity of coronary artery disease, ischemia, and symptom burden in patients with moderate or severe ischemia. JAMA Cardiol. 2020;5(7):773. https://doi.org/10.1001/jamacardio.2020.0822.Reynolds HR, Shaw LJ, Min JK et al. Association of sex with severity of coronary artery disease, ischemia, and symptom burden in patients with moderate or severe ischemia. JAMA Cardiol. 2020;5(7):773. https://doi.org/10.1001/jamacardio.2020.0822.Beibalaeva AM, Kudaev MT, Gadjieva TA et al. Myocardial infacrtion − peculiarities of the damage of the coronary core and risk factors in men and women. Bulletin of New Medical Technologies = Vestnik novyh medicinskih tehnologij. 2019;(6):17−22. (In Russ.). https://doi.org/10.24411/2075-4094-2019-16520.Бейбалаева А.М., Кудаев М.Т., Гаджиева Т.А. с соавт. Инфаркт миокарда − особенности поражения коронарного русла и факторы риска у мужчин и женщин. Вестник новых медицинских технологий. 2019;(6):17−22. https://doi.org/10.24411/2075-4094-2019-16520.Pelliccia F, Kaski JC, Crea F, et al. Pathophysiology of Takotsubo syndrome. Circulation. 2017;135(24):2426–2441. https://doi.org/10.1161/circulationaha.116.027121.Pelliccia F, Kaski JC, Crea F, et al. Pathophysiology of Takotsubo syndrome. Circulation. 2017;135(24):2426–2441. https://doi.org/10.1161/circulationaha.116.027121.Medina de Chazal H, Del Buono MG, Keyser-Marcus L et al. Stress cardiomyopathy diagnosis and treatment. J Am Coll Cardiol. 2018;72(16):1955–71. https://doi.org/10.1016/j.jacc.2018.07.072.Medina de Chazal H, Del Buono MG, Keyser-Marcus L et al. Stress cardiomyopathy diagnosis and treatment. J Am Coll Cardiol. 2018;72(16):1955–71. https://doi.org/10.1016/j.jacc.2018.07.072.Ghadri J-R, Wittstein IS, Prasad A et al. International expert consensus document on Takotsubo syndrome (Part I): clinical characteristics, diagnostic criteria, and pathophysiology. Eur Heart J. 2018;39(22):2032–2046. https://doi.org/10.1093/eurheartj/ehy076.Ghadri J-R, Wittstein IS, Prasad A et al. International expert consensus document on Takotsubo syndrome (Part I): clinical characteristics, diagnostic criteria, and pathophysiology. Eur Heart J. 2018;39(22):2032–2046. https://doi.org/10.1093/eurheartj/ehy076.Saw J, Aymong E, Sedlak T et al. Spontaneous coronary artery dissection. Circulation Cardiovasc Interv. 2014;7(5):645– 655. https://doi.org/10.1161/circinterventions.114.001760.Saw J, Aymong E, Sedlak T et al. Spontaneous coronary artery dissection. Circulation Cardiovasc Interv. 2014;7(5):645– 655. https://doi.org/10.1161/circinterventions.114.001760.Saw J, Starovoytov A, Humphries K et al. Canadian spontaneous coronary artery dissection cohort study: in-hospital and 30-day outcomes. Eur Heart J. 2019;40(15):1188–1197. https://doi.org/10.1093/eurheartj/ehz007.Saw J, Starovoytov A, Humphries K et al. Canadian spontaneous coronary artery dissection cohort study: in-hospital and 30-day outcomes. Eur Heart J. 2019;40(15):1188–1197. https://doi.org/10.1093/eurheartj/ehz007.Tweet MS, Hayes SN, Pitta SR et al. Clinical features, management, and prognosis of spontaneous coronary artery dissection. Circulation. 2012;126(5):579–588. https://doi.org/10.1161/circulationaha.112.105718.Tweet MS, Hayes SN, Pitta SR et al. Clinical features, management, and prognosis of spontaneous coronary artery dissection. Circulation. 2012;126(5):579–588. https://doi.org/10.1161/circulationaha.112.105718.Lobo AS, Cantu SM, Sharkey SW et al. Revascularization in patients with spontaneous coronary artery dissection and st-segment elevation myocardial infarction. J Am College Cardiol. 2019;74(10):1290–1300. https://doi.org/10.1016/j.jacc.2019.06.065.Lobo AS, Cantu SM, Sharkey SW et al. Revascularization in patients with spontaneous coronary artery dissection and st-segment elevation myocardial infarction. J Am College Cardiol. 2019;74(10):1290–1300. https://doi.org/10.1016/j.jacc.2019.06.065.Lempereur M, Gin K, Saw J. Multivessel spontaneous coronary artery dissection mimicking atherosclerosis. JACC Cardiovasc Interv. 2014;7(7):e87–88. https://doi.org/10.1016/j.jcin.2013.12.207.Lempereur M, Gin K, Saw J. Multivessel spontaneous coronary artery dissection mimicking atherosclerosis. JACC Cardiovasc Interv. 2014;7(7):e87–88. https://doi.org/10.1016/j.jcin.2013.12.207.Brodovskaya TO, Saeed S, Babykina EG et al. Invasive and conservative treatment of spontaneous coronary artery dissection: a meta-analysis. Ural Medical Journal. 2022;21(5):102−115. (In Russ.). https://doi.org/10.52420/2071-5943-2022-21-5-102-115.Бродовская Т.О., Саид С., Бабыкина Е.Г. с соавт. Инвазивное и консервативное лечение спонтанной диссекции коронарных артерий: метаанализ. Уральский медицинский журнал. 2022;21(5):102−115. https://doi.org/10.52420/2071-5943-2022-21-5-102-115.Murthy VL, Naya M, Taqueti VR et al. Effects of sex on coronary microvascular dysfunction and cardiac outcomes. Circulation. 2014;129(24):2518–2527. https://doi.org/10.1161/circulationaha.113.008507.Murthy VL, Naya M, Taqueti VR et al. Effects of sex on coronary microvascular dysfunction and cardiac outcomes. Circulation. 2014;129(24):2518–2527. https://doi.org/10.1161/circulationaha.113.008507.Ang DTY, Berry C, Kaski J-C. Phenotype-based management of coronary microvascular dysfunction. J Nucl Cardiol. 2022;29(6):3332–3340. https://doi.org/10.1007/s12350-022-03000-w.Ang DTY, Berry C, Kaski J-C. Phenotype-based management of coronary microvascular dysfunction. J Nucl Cardiol. 2022;29(6):3332–3340. https://doi.org/10.1007/s12350-022-03000-w.Damman P, Elias-Smale SE, Jansen TPJ et al. Contemporary and future invasive coronary vasomotor function testing and treatment in patients with ischaemia with no obstructive coronary arteries. Eur Heart J Suppl. 2022;24:H18–H24. https://doi.org/10.1093/eurheartjsupp/suac053.Damman P, Elias-Smale SE, Jansen TPJ et al. Contemporary and future invasive coronary vasomotor function testing and treatment in patients with ischaemia with no obstructive coronary arteries. Eur Heart J Suppl. 2022;24:H18–H24. https://doi.org/10.1093/eurheartjsupp/suac053.Spione F, Arevalos V, Gabani R et al. Coronary microvascular angina: a state-of-the-art review. Front Cardiovasc Med. 2022;9. https://doi.org/10.3389/fcvm.2022.800918.Spione F, Arevalos V, Gabani R et al. Coronary microvascular angina: a state-of-the-art review. Front Cardiovasc Med. 2022;9. https://doi.org/10.3389/fcvm.2022.800918.Zhao M, Woodward M, Vaartjes I et al. Sex differences in cardiovascular medication prescription in primary care: a systematic review and meta-analysis. J Am Heart Assoc. 2020;9(11):e014742. https://doi.org/10.1161/jaha.119.014742.Zhao M, Woodward M, Vaartjes I et al. Sex differences in cardiovascular medication prescription in primary care: a systematic review and meta-analysis. J Am Heart Assoc. 2020;9(11):e014742. https://doi.org/10.1161/jaha.119.014742.Tamargo J, Rosano G, Walther T et al. Gender differences in the effects of cardiovascular drugs. Eur Heart J Cardiovasc Pharmacother. 2017;3(3):163–182. https://doi.org/10.1093/ehjcvp/pvw042.Tamargo J, Rosano G, Walther T et al. Gender differences in the effects of cardiovascular drugs. Eur Heart J Cardiovasc Pharmacother. 2017;3(3):163–182. https://doi.org/10.1093/ehjcvp/pvw042.Pagidipati NJ, Coles A, Hemal K et al. Sex differences in management and outcomes of patients with stable symptoms suggestive of coronary artery disease: Insights from the PROMISE trial. Am Heart J. 2019;208:28–36. https://doi.org/10.1016/j.ahj.2018.11.002.Pagidipati NJ, Coles A, Hemal K et al. Sex differences in management and outcomes of patients with stable symptoms suggestive of coronary artery disease: Insights from the PROMISE trial. Am Heart J. 2019;208:28–36. https://doi.org/10.1016/j.ahj.2018.11.002.Gaudino M, Di Franco A, Cao D et al. Sex-related outcomes of medical, percutaneous, and surgical interventions for coronary artery disease: JACC Focus Seminar. J Am Coll Cardiol. 2022;79(14):1407–1425. https://doi.org/10.1016/j.jacc.2021.07.066.Gaudino M, Di Franco A, Cao D et al. Sex-related outcomes of medical, percutaneous, and surgical interventions for coronary artery disease: JACC Focus Seminar. J Am Coll Cardiol. 2022;79(14):1407–1425. https://doi.org/10.1016/j.jacc.2021.07.066.Lee CMY, Mnatzaganian G, Woodward M et al. Sex disparities in the management of coronary heart disease in general practices in Australia. Heart. 2019;105(24):1898–1904. https://doi.org/10.1136/heartjnl-2019-315134.Lee CMY, Mnatzaganian G, Woodward M et al. Sex disparities in the management of coronary heart disease in general practices in Australia. Heart. 2019;105(24):1898–1904. https://doi.org/10.1136/heartjnl-2019-315134.Jortveit J, Govatsmark RES, Langørgen J et al. Gender differences in the assessment and treatment of myocardial infarction. Tidsskr Nor Laegeforen. 2016;136(14−15):1215–1222. https://doi.org/10.4045/tidsskr.16.0224.Jortveit J, Govatsmark RES, Langørgen J et al. Gender differences in the assessment and treatment of myocardial infarction. Tidsskr Nor Laegeforen. 2016;136(14−15):1215–1222. https://doi.org/10.4045/tidsskr.16.0224.Nanna MG, Wang TY, Xiang Q et al. Sex differences in the use of statins in community practice. Circ Cardiovasc Qual Outcomes. 2019;12(8):e005562. https://doi.org/10.1161/circoutcomes.118.005562.Nanna MG, Wang TY, Xiang Q et al. Sex differences in the use of statins in community practice. Circ Cardiovasc Qual Outcomes. 2019;12(8):e005562. https://doi.org/10.1161/circoutcomes.118.005562.Shalnova SA, Deev AD, Metelskaya VA et al. Awareness and treatment specifics of statin therapy in persons with various cardiovascular risk: the study ECVD-RF. Cardiovascular therapy and prevention = Kardiovaskuljarnaja terapija i profilaktika. 2016;15(4):29−37. (In Russ.). https://doi.org/10.15829/1728-8800-2016-4-29-37.Шальнова С.А., Деев А.Д., Метельская В.А. с соавт. Информированность и особенности терапии статинами у лиц с различным сердечно-сосудистым риском: исследование ЭССЕ-РФ. Кардиоваскулярная терапия и профилактика. 2016;15(4):29−37. https://doi.org/10.15829/1728-8800-2016-4-29-37.Tran VH, Mehawej J, Abboud DM et al. Age and sex differences and temporal trends in the use of invasive and noninvasive procedures in patients hospitalized with acute myocardial infarction. J Am Heart Assoc. 2022;11(17):e025605. https://doi.org/10.1161/jaha.122.025605.Tran VH, Mehawej J, Abboud DM et al. Age and sex differences and temporal trends in the use of invasive and noninvasive procedures in patients hospitalized with acute myocardial infarction. J Am Heart Assoc. 2022;11(17):e025605. https://doi.org/10.1161/jaha.122.025605.Andreushkov AR. Comparison of results of early and delayed PCI in patients with ACS without ST segment elevation. System analysis of RCT. Ural Medical Journal. 2020;7(190):46−49. (In Russ.). https://doi.org/10.25694/URMJ.2020.07.11.Андрюшков А.Р. Сравнение результатов раннего и отсроченного ЧКВ у больных с ОКС без подъема сегмента ST. Системный анализ РКИ. Уральский медицинский журнал. 2020;07(190): 46−49. https://doi.org/10.25694/URMJ.2020.07.11.Gaudino M, Di Franco A, Cao D et al. Sex-related outcomes of medical, percutaneous, and surgical interventions for coronary artery disease. J Am Coll Cardiol. 2022;79(14):1407–25. https://doi.org/10.1016/j.jacc.2021.07.066.Gaudino M, Di Franco A, Cao D et al. Sex-related outcomes of medical, percutaneous, and surgical interventions for coronary artery disease. J Am Coll Cardiol. 2022;79(14):1407–25. https://doi.org/10.1016/j.jacc.2021.07.066.Andreenko EY, Yavelov IS, Loukianov ММ et al. Ischemic heart disease in subjects of young age: current state of the problem. features of etiology, clinical manifestation and prognosis. Cardiology = Kardiologija. 2018;58(11):24−34. (In Russ.). https://doi.org/10.18087/cardio.2018.11.10195.Андреенко Е.Ю., Явелов И.С., Лукьянов М.М. с соавт. Ишемическая болезнь сердца у лиц молодого возраста: особенности этиологии, клинических проявлений и прогноза. Кардиология. 2018;58(11):24−34. https://doi.org/10.18087/cardio.2018.11.10195.Jespersen L, Hvelplund A, Abildstrom SZ et al. Stable angina pectoris with no obstructive coronary artery disease is associated with increased risks of major adverse cardiovascular events. Eur Heart J. 2011;33(6):734–744. https://doi.org/10.1093/eurheartj/ehr331.Jespersen L, Hvelplund A, Abildstrom SZ et al. Stable angina pectoris with no obstructive coronary artery disease is associated with increased risks of major adverse cardiovascular events. Eur Heart J. 2011;33(6):734–744. https://doi.org/10.1093/eurheartj/ehr331.Shalnova SA, Drapkina OM. The trends of cardiovascular and cancer mortality in russian men and women from 2000 to 2016 years. Rational Pharmacotherapy in Cardiology = Racional’naja farmakoterapija v kardiologii. 2019;15(1):77−83. (In Russ.). https://doi.org/10.20996/1819-6446-2019-15-1-77-83.Шальнова С.А., Драпкина О.М. Тренды смертности от болезней системы кровообращения и злокачественных новообразований у российских мужчин и женщин 200−2016 гг. Рациональная фармакотерапия в кардиологии. 2019;15(1):77−83. https://doi.org/10.20996/1819-6446-2019-15-1-77-83.Шальнова С.А., Драпкина О.М. Тренды смертности от болезней системы кровообращения и злокачественных новообразований у российских мужчин и женщин 200−2016 гг. Рациональная фармакотерапия в кардиологии. 2019;15(1):77−83. https://doi.org/10.20996/1819-6446-2019-15-1-77-83.

The authors declare that there are no conflicts of interest present.