Women are more than twice as likely to die after a heart attack than men, according to research presented at Heart Failure 2023, a scientific congress of the European Society of Cardiology (ESC).
“Women of all ages who suffer from myocardial infarction they run a particularly high risk of having a poor prognosis,” says the author of the study, Dr. Mariana Martinho, from the García de Orta de Almada Hospital (Portugal).
“These women need regular follow-up after the heart attack, with close control of blood pressure, cholesterol levels and diabetes, and referral to Cardiac Rehabilitation”, he exposed.
Previous studies have shown that the prognosis of women with ST-segment elevation myocardial infarction (STEMI) during their hospital stay is worse than that of men, and that this may be due to their older age, greater number of other conditions and less use of stents (percutaneous coronary intervention; PCI) to open the aclogged arteries.
This study compared short- and long-term outcomes after STEMI in women and men, examining whether there were gender differences in both premenopausal women (55 years or younger) and postmenopausal (Over 55 years old).
This is a retrospective observational study that included consecutive patients admitted for STEMI and treated with PCI within 48 hours of symptom onset between 2010 and 2015.
Adverse outcomes were defined as mortality all-cause mortality at 30 days, all-cause mortality at five years, and cardiovascular events major adverse events (MACE; a composite of all-cause death, reinfarction, hospitalization for heart failure, and ischemic stroke) at five years.
In it study 884 patients participated with a mean age of 62 years and 27% were women. Women were older than men (67 vs. 60 years on average) and had higher rates of arterial hypertension, diabetes and previous stroke. Men were more likely to be smokers and have coronary heart disease.
The interval between symptoms and PCI treatment did not differ between women and men overall, but women women age 55 or younger they had a significantly longer delay in treatment after arriving at hospital than their male counterparts (95 vs. 80 minutes).
The researchers compared the risk of adverse outcomes between women and men after adjusting for factors that could influence the relationship, such as diabeteshypercholesterolemia, hypertensioncoronary artery disease, heart failure, chronic kidney disease, peripheral artery disease, stroke, and a family history of coronary artery disease.
At 30 days, 11.8% of the women had died, compared with 4.6% of the men, which implies a risk ratio (HR) of 2.76. At five years, almost a third of the women (32.1%) had died versus 16.9% of the men (HR 2.33). More than a third of women (34.2%) experienced MACE within five years, compared to 19.8% of men (HR 2.10).
“Women were two to three times more likely to suffer adverse outcomes than men in the short and long term, even after adjusting for other conditions and despite receiving PCI in the same term as men”, explains Dr. Martinho.