Why women are more likely to die following heart attack than men

According to findings presented at Heart Failure 2023 a scientific congress of the European Society of Cardiology ESC women are more than twice as likely as males to die following a heart attackWomen of all ages who experience a myocardial infarction are at particularly high risk of a poor prognosis said study author Dr Mariana Martinho of Hospital Garcia de Orta Almada Portugal These women need regular monitoring after their heart event with strict control of blood pressure cholesterol levels and diabetes and referral to cardiac rehabilitation Smoking levels are rising in young women and this should be tackled along with promoting physical activity and healthy livingPrevious studies have found that women with STelevation myocardial infarction STEMI have a worse prognosis during their hospital stay compared to men and that this may be due to their older age increased numbers of other conditions and less use of stents percutaneous coronary intervention PCI to open blocked arteries2 This study compared short and longterm outcomes after STEMI in women and men and examined whether any sex differences were apparent in both premenopausal 55 years and under and postmenopausal over 55 womenThis was a retrospective observational study that enrolled consecutive patients admitted with STEMI and treated with PCI within 48 hours of symptom onset between 2010 and 2015 Adverse outcomes were defined as 30day allcause mortality fiveyear allcause mortality and fiveyear major adverse cardiovascular events MACE a composite of allcause death reinfarction hospitalisation for heart failure and ischaemic strokeThe study included 884 patients The average age was 62 years and 27 per cent were women Women were older than men average age 67 vs 60 years and had higher rates of high blood pressure diabetes and prior stroke Men were more likely to be smokers and have coronary artery disease The interval between symptoms and treatment with PCI did not differ between women and men overall but women aged 55 and below had a significantly longer treatment delay after arriving at the hospital than their male peers 95 vs 80 minutesThe researchers compared the risk of adverse outcomes between women and men after adjusting for factors that could influence the relationship including diabetes high cholesterol hypertension coronary artery disease heart failure chronic kidney disease peripheral artery disease stroke and family history of coronary artery disease At 30 days 118 per cent of women had died compared to 46 per cent of men for a hazard ratio HR of 276 At five years nearly onethird of women 321 per cent had died versus 169 per cent of men HR 233 More than onethird of women 342 per cent experienced MACE within five years compared with 198 per cent of men HR 210Dr Martinho said Women had a two to three times higher likelihood of adverse outcomes than men in the short and longterm even after adjusting for other conditions and despite receiving PCI within the same timeframe as menThe researchers conducted a further analysis in which they matched men and women according to risk factors for cardiovascular disease including hypertension diabetes high cholesterol and smoking Adverse outcomes were then compared between matched men and women aged 55 years and under and between matched men and women over 55 years oldThere were 435 patients in the matched analysis In matched patients over 55 years of age all adverse outcomes measured were more common in women than men Some 113 per cent of women died within 30 days compared with 30 per cent of men for an HR of 385 At five years onethird of women 329 per cent had died compared with 158 per cent of men HR 235 and more than onethird of women 341 per cent had experienced MACE compared with 176 per cent of men HR 215 In matched patients aged 55 years and below one in five women 200 per cent experienced MACE within five years compared to 58 per cent of men HR 391 while there were no differences between women and men in allcause mortality at 30 days or five yearsDr Martinho said Postmenopausal women had worse short and longterm outcomes after myocardial infarction than men of similar age Premenopausal women had similar shortterm mortality but a poorer prognosis in the longterm compared with their male counterparts While our study did not examine the reasons for these differences atypical symptoms of myocardial infarction in women and genetic predisposition may play a role We did not find any differences in the use of medications to lower blood pressure or lipid levels between women and menShe concluded The findings are another reminder of the need for greater awareness of the risks of heart disease in women More research is required to understand why there is gender disparity in prognosis after myocardial infarction so that steps can be taken to close the gap in outcomesAlso Read Stress and heart attack quietly killing Mumbairsquos policemenThis story has been sourced from a third party syndicated feed 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