Study Finds Women are More than Twice as Likely to Die After a Heart Attack than Men
Key Highlights :
The risk of heart disease in women is often overlooked, but a new study suggests that women are more than twice as likely to die after a heart attack than men. The research, which was presented at Heart Failure 2023, a scientific congress of the European Society of Cardiology, found that women aged 55 and below also had to wait 15 minutes longer for treatment after arriving at hospital.
The study compared short and long-term outcomes after a ST-elevation myocardial infarction (STEMI) in women and men, and looked at whether any sex differences were apparent in both premenopausal (55 years and under) and postmenopausal (over 55) women. The study included 884 patients, with an average age of 62 years and 27% were women.
Women were older than men (average age 67 versus 60 years) and had higher rates of high blood pressure, diabetes and prior stroke, researchers found. Men were more likely to be smokers and have coronary artery disease. While the time between symptoms and treatment with stents did not differ between women and men overall, premenopausal women had a significantly longer treatment delay after arriving at hospital than their male peers - 95 versus 80 minutes.
At 30 days, 11.8% of women had died compared with 4.6% of men. At five years, nearly one-third of women (32.1%) had died compared with 16.9% of men. Meanwhile more than one-third of women (34.2%) experienced major adverse cardiovascular events within five years compared with 19.8% of men.
The researchers conducted a further analysis in which they matched 435 men and women according to risk factors for heart disease including hypertension, diabetes, high cholesterol and smoking. In matched patients over 55 years of age, all adverse outcomes measured were more common in women than men, the study found. Some 11.3% of women died within 30 days compared with 3.0% of men. At five years, one-third of women (32.9%) had died compared with 15.8% of men.
Experts suggest the worse prognosis in women may be because of their older age, increased numbers of other conditions, and stents being used less to open blocked arteries. The findings are a reminder of the need for greater awareness of the risks of heart disease in women, and 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 outcomes.
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 living.
The findings of the study are a stark reminder of the need to take heart disease in women seriously, and to ensure that all women receive the same level of care and attention as men. With greater awareness, more research and better treatment options, it is hoped that the gender disparity in prognosis after a heart attack can be closed in the future.
