Nonobstructive CAD, Women, and Prevention of Cardiovascular Events

Cardiologists are acknowledging the need to better refine cardiovascular risk assessment in women.  According to information recently published in the Journal of the American College of Cardiology, women are more likely to have nonobstructive coronary artery disease (CAD) than men.  Since nonobstructive CAD, characterized by soft plaque, is known to precede plaque rupture that can lead to devastating cardiovascular events, there is reason for practitioners to pay attention to these gender differences.The authors attested to the value of assessing “coronary microvascular and/or endothelial dysfunction” since both were associated with nonobstructive CAD. They pointed to information obtained from the Women’s Ischemic Syndrome Evaluation (WISE) database over a 10 year period that showed a significant increase in the risk of cardiovascular events in women with nonobstructive CAD vs. those without. The authors noted that the presence of risk factors such as pre-diabetes, diabetes, hypertension, etc. in women should alert clinicians to consider/look for signs and symptoms of nonobstructive CAD.

A related commentary by the world renowned Valentine Fuster addresses the concept of nonobstructive CAD in women as an “emerging paradigm” related to the cause of adverse events in women.

Reference:  Emergence of Nonobstructive Coronary Artery Disease: A Woman’s Problem and Need for Change in Definition on Angiography. J Am Coll Cardiol 2015;66:1918-1933.

See: Nonobstructive Coronary Artery Disease in Women and Emergence of Nonobstructive Coronary Artery Disease: A Woman’s Problem and Need for Change in Definition on Angiography. J Am Coll Cardiol 2015;66:1918-1933.

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