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KEY POINTS

■ Women who present for percutaneous coronary intervention (PCI) are older and have more comorbidities than men. Women and men have similar short- and long-term mortality rate after PCI. However, women have 1.5 to 4 times higher vascular complication and bleeding rates than men.

■ The diagnosis of microvessel dysfunction should be considered in women who have abnormal stress test results with perfusion defect but minimal coronary artery disease on angiography.

■ Women and men have similar benefit with glycoprotein IIb/IIIa inhibitor, adenosine diphosphate (ADP) receptor inhibitors, and direct thrombin inhibitors. The benefit of aspirin in secondary prevention is well known in women and men. However, aspirin and primary prevention differ between men and women. Women have fewer ischemic strokes and men have fewer myocardial infarctions with aspirin therapy.

■ Race-specific analyses in PCI are still rare. However, African American patients who present for PCI are younger, female, and more likely to have comorbidities and present with acute coronary syndromes (ACS) or ST-segment elevation myocardial infarction (STEMI).

■ African American patients have a lower long-term survival rate after PCI than their white counterparts.

Cardiovascular disease (CVD) remains the leading cause of death in the United States, regardless of gender and race.1 Until recently, information extrapolated from large studies and registries has been applied to all population groups irrespective of gender, race, or ethnicity. However, there is a growing body of literature that has shown differences in CVD manifestation and treatment based on gender and race. This chapter explores gender and racial differences in percutaneous coronary intervention (PCI), acute myocardial infarction (MI), acute coronary syndromes (ACS), stable angina, and adjunctive pharmacotherapy.

CVD is the leading cause of mortality and morbidity in women in the United States. It claims the lives of more women then the next five major causes of death in women combined.1 CVD in women occurs about 10 years later than in men, and in part this has contributed to the misconception that CVD is predominantly a problem of male gender. Many of the outcome differences reported between women and men may be explained by differences in comorbidi-ties, pathophysiologic differences between genders, and disparities in treatment and outcomes after the cardiovascular event.1

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