Sex and gender differences in coronary pathophysiology and ischaemic heart disease.

This Scientific Statement provides an updated review of the current knowledge from risk factors to prognosis.

本科学声明提供了从风险因素到预后的当前知识的更新审查。

It discusses the unequal impact of certain traditional risk factors between men and women, along with additional factors, such as hormonal changes and treatments (including those for transgender people and cancer), pregnancy-related complications, and autoimmune diseases, which contribute to the sex-specific risk profiles.

它探讨了某些传统风险因素在男性和女性之间不平等的影响，以及额外的因素，如激素变化和治疗（包括跨性别者和癌症患者的治疗）、与怀孕相关的并发症以及自身免疫疾病，这些因素共同构成了性别特定的风险概况。

Moreover, it outlines functional and structural sex differences in the pathophysiology (e.g. coronary atheroma plaques and burden, coronary dissection, vasospasm, and microvascular disease) with women being more prone to microvascular disease and endothelial dysfunction, while paradoxically experiencing less severe myocardial ischaemia at similar levels of coronary stenosis.

此外，它概述了病理生理学中的功能性和结构性性别差异（例如冠状动脉粥样硬化斑块和负担、冠状动脉夹层、血管痉挛和微血管疾病），女性更容易出现微血管疾病和内皮功能障碍，而具有类似的冠状动脉狭窄水平时，却经历较轻微的心肌缺血。

The document further addresses the evaluation of diagnostic tools, which often have a male-centric bias, resulting in underdiagnosis in women who also tend to receive less guideline-recommended treatment.

该文件进一步讨论了诊断工具的评估，这些工具往往存在男性中心偏见，导致女性的诊断不足，她们也往往接受较少的指南推荐治疗。

Additionally, women can have different responses and side effects to various preventive and therapeutic treatments, potentially contributing to the worse prognosis documented in acute coronary syndromes with obstructive coronary artery disease, particularly at a young age.

此外，女性对各种预防和治疗性治疗的反应和副作用可能不同，这可能有助于在急性冠状动脉综合征中记录到的更差的预后，特别是在年轻时患有阻塞性冠状动脉疾病。

Considering all these sex and gender differences and the low enrolment of women in randomized controlled trials, questions arise regarding the optimal treatment for women.

鉴于所有这些性别差异以及女性在随机对照试验中的低入组率，对于女性的最佳治疗方案产生了疑问。

Addressing sex differences requires conducting sex-specific research to close the knowledge gap.

解决性别差异需要进行特定性别的研究，以填补知识空白。

Overall, the Scientific Statement highlights all relevant sex- and gender-specific dissimilarities to advance clinical practice and identify directions for future research to improve guideline recommendations for equitable care.

总的来说，科学声明强调了所有相关的性别差异，以推动临床实践，并确定未来研究的方向，以改善公平护理的指南建议。