The lack of sensitivity and specificity of regular treadmill testing in women has led to a marked increase in studies involving exercise testing with echocardiographic or nuclear imaging. The increasing availability of prognostic as well as diagnostic information from these studies continues to refine noninvasive testing for women. In another study, although abnormal sestamibi scans were equally predictive of adverse events in women and men, the types of events differed. Women with abnormal scans were more likely to develop unstable angina and heart failure, and men were more likely to develop myocardial infarction and cardiac death. 12 Treatment of CAD in women Cardiovascular disease may still be treated less aggressively in women, despite a growing awareness that coronary artery disease is the leading cause of death for women.
Evidence suggests that men and women benefit equally from thrombolytic therapy.
13 Women with myocardial infarctions are older, have more comorbidities, and have more severe cardiac disease than men with myocardial infarctions. Even in allowing for these baseline differences, elderly female patients and nonwhite patients are undertreated with thrombolytic therapy. 16 Women tend to experience a higher mortality from myocardial infarction due to their older age at presentation, greater frequency of diabetes, and a greater degree of cardiac dysfunction on presentation. The outcome for patients with unstable angina and non-Q wave myocardial infarction is related to severity of underlying CAD, and not to gender. The extent of CAD was similar in women and men, and CABG and angioplasty were equally effective in both groups.