Sex, Racial, and Ethnic Disparities in Acute Coronary Syndrome: Novel Risk Factors and Recommendations for Earlier Diagnosis to Improve Outcomes

Arterioscler Thromb Vasc Biol. 2023 Aug;43(8):1369-1383. doi: 10.1161/ATVBAHA.123.319370. Epub 2023 Jun 29.

Abstract

In this review, sex, racial, and ethnic differences in acute coronary syndromes on a global scale are summarized. The relationship between disparities in presentation and management of acute coronary syndromes and effect on worse clinical outcomes in acute coronary syndromes are discussed. The effect of demographic, geographic, racial, and ethnic factors on acute coronary syndrome care disparities are reviewed. Differences in risk factors including systemic inflammatory disorders and pregnancy-related factors and the pathophysiology underlying them are discussed. Finally, breast arterial calcification and coronary calcium scoring are discussed as methods to detect subclinical atherosclerosis and start early treatment in an attempt to prevent clinical disease.

Keywords: acute coronary syndrome; cardiovascular diseases; coronary artery disease; myocardial infarction; risk factors.

Publication types

  • Review

MeSH terms

  • Acute Coronary Syndrome* / diagnosis
  • Acute Coronary Syndrome* / therapy
  • Atherosclerosis*
  • Humans
  • Racial Groups
  • Risk Factors
  • Sex Factors