Sex, gender and coronary heart disease: a view through the prism of antianginal therapy

The significance of sex and gender differences in the diagnosis, course and treatment of cardiovascular disease is gaining attention around the world. This issue is particularly acute for Ukraine, which has been ranked first in the global ranking of countries with the highest cardiovascular mortality rate among women for 11 years. There is convincing evidence of sex and gender cardiovascular risk factors that contribute to the emergence of sex and gender differences in the clinical picture of coronary artery disease (CAD) and the effectiveness of its pharmacotherapy. Currently, there are no recommendations for sex and gender-specific management of patients with CAD. The first antianginal drug that has begun to accumulate evidence of efficacy in the female population is ranolazine. It is approved by the FDA and EMA, and recommended by AHA and ESC experts for the treatment of ischemic heart disease due to its ability to reduce the symptoms of angina and myocardial ischemia, improve carbohydrate metabolism and calm the heart rate. These benefits allow to recommend ranolazine to women with obstructive CAD, microvascular dysfunction or ischemia in the absence of coronary artery obstruction, myocardial infarction in non-obstructive coronary artery disease with concomitant atrial fibrillation, diabetes mellitus.

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