THE ROLE OF THE IMMUNE SYSTEM IN CORONARY HEART DISEASE IN WOMEN

The three most important characteristics of CHD in women are: 1) a higher prevalence of angina, 2) a lower burden of obstructive CHD on angiography, and 3) a worse prognosis compared with men. In addition, current risk estimates based on ACS thresholds defined in predominantly male populations do not accurately predict risk in women, suggesting the need for gender-specific biomarker ranges and risk stratification tools to improve diagnosis, treatment, and follow-up in female populations. In a recent prospective cohort study, the highly sensitive troponin I assay markedly increased the diagnosis of MI in women (from 11% to 22%, P<0.001) but had minimal impact in men (19% to 21%, P=0.002). Other biomarkers, such as proneurotensin, were found to be sex-dependent and associated with cardiovascular disease only in women, confirming the need for additional research in this area [132,138].