Gender differences in patients with carotid stenosis

TY - JOUR

T1 - Gender differences in patients with carotid stenosis

AU - Stoberock, Konstanze

AU - Debus, Eike Sebastian

AU - Atlihan, Gülsen

AU - Daum, Günter

AU - Larena-Avellaneda, Axel

AU - Eifert, Sandra

AU - Wipper, Sabine

PY - 2016/1

Y1 - 2016/1

N2 - This overview analyses gender differences in prevalence, epidemiology, risk factors and therapy in patients with carotid stenosis in a systematic review. Ischemic stroke is a leading cause of death in Western society, where about 20% of cases are triggered by a carotid stenosis or occlusion, which occurs more frequently in men than in women. The stroke-protective effect of carotid endarterectomy is greater in men. Men have lower peri-procedural stroke and death rates. Particularly men with carotid stenosis and a life expectancy of at least 5 years benefit from surgical treatment. Also, the recurrence rate of ipsilateral stroke 5 years after initial surgery is lower in men than in women. It is not yet fully clarified whether there are significant gender differences regarding the outcome after endovascular versus surgical treatment. Gender differences in the outcome of carotid artery repair may be caused by biological, anatomical (smaller vessel diameter in women) or hormonal differences as well as a protracted development of atherosclerotic changes in women and different plaque morphology. Moreover, women are on average older at the time of surgery and their surgical treatment is often delayed. To reduce the risk of stroke and to improve treatment outcome especially for women, further research on gender differences and their causes is mandatory and promising.

AB - This overview analyses gender differences in prevalence, epidemiology, risk factors and therapy in patients with carotid stenosis in a systematic review. Ischemic stroke is a leading cause of death in Western society, where about 20% of cases are triggered by a carotid stenosis or occlusion, which occurs more frequently in men than in women. The stroke-protective effect of carotid endarterectomy is greater in men. Men have lower peri-procedural stroke and death rates. Particularly men with carotid stenosis and a life expectancy of at least 5 years benefit from surgical treatment. Also, the recurrence rate of ipsilateral stroke 5 years after initial surgery is lower in men than in women. It is not yet fully clarified whether there are significant gender differences regarding the outcome after endovascular versus surgical treatment. Gender differences in the outcome of carotid artery repair may be caused by biological, anatomical (smaller vessel diameter in women) or hormonal differences as well as a protracted development of atherosclerotic changes in women and different plaque morphology. Moreover, women are on average older at the time of surgery and their surgical treatment is often delayed. To reduce the risk of stroke and to improve treatment outcome especially for women, further research on gender differences and their causes is mandatory and promising.

KW - Angioplasty/instrumentation

KW - Asymptomatic Diseases

KW - Carotid Stenosis/diagnosis

KW - Endarterectomy, Carotid

KW - Female

KW - Health Status Disparities

KW - Healthcare Disparities

KW - Humans

KW - Male

KW - Prevalence

KW - Recurrence

KW - Risk Assessment

KW - Risk Factors

KW - Sex Factors

KW - Stroke/diagnosis

KW - Time Factors

KW - Treatment Outcome

U2 - 10.1024/0301-1526/a000490

DO - 10.1024/0301-1526/a000490

M3 - SCORING: Review article

C2 - 26986705

VL - 45

SP - 11

EP - 16

JO - VASA

JF - VASA

SN - 0301-1526

IS - 1

ER -