Sex Differences in Acute Coronary Syndrome Presentation and Management: Twenty Years On, What Has Actually Narrowed

Abstract

Sex differences in acute coronary syndrome (ACS) have been documented since the early 2000s: women present with
somewhat different symptoms, wait longer for reperfusion, receive guideline-directed medical therapy (GDMT) less often,
and have historically fared worse after myocardial infarction (MI) than men. Two decades on, cardiology has produced a
substantial further body of registry data and meta-analyses on this question. What has rarely been asked as directly is whether
any of these specific gaps has actually narrowed, or whether 'awareness' of the disparity has simply become part of the
literature without changing the numbers underneath it.