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Sex-related differences in coronary vasomotor disorders: Comparisons between Western and Japanese populations

      Highlights

      • Gender differences in the prevalence of cardiac disease are elucidated.
      • Gender differences in the clinical features and outcomes remain uncertain.
      • The clinical outcomes of Western patients with coronary microvascular dysfunction were less satisfactory.
      • Japanese patients with coronary epicardial spasm treated with medications including calcium channel blockers were favorable.
      • Review of the sex differences in Japanese patients with coronary vasomotor disorders

      Abstract

      Sex-related differences in the prevalence of cardiac disorders have been elucidated beyond races. Angina/ischemia with nonobstructive coronary artery disease (AINOCA) is often observed in females. Coronary microvascular dysfunction (CMD) and coronary epicardial spasm (CES) are the principal cause of AINOCA. The clinical outcomes of Western patients with CMD were less satisfactory than expected, while the prognosis of Japanese patients with CES treated with medications including calcium channel blockers was favorable. However, the incidence and clinical features of coronary spasm endotypes were different between Western and Japanese populations. Furthermore, sex-related differences in the clinical manifestations and outcomes of patients with different spasm endotypes remain uncertain beyond race. In this article, we will review the sex differences in Japanese AINOCA patients with coronary vasomotor disorders, including CMD and CES, and compare them with those of Western patients.

      Graphical abstract

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