Women twice as likely to die following a heart attack than men: study

By Alice Clifford via SWNS

Women are twice as likely to die following a heart attack as men, warns a new study.

Previous studies have found that women with ST-elevation myocardial infarction, or STEMI, have a worse prognosis during their hospital stay compared to men.

STEMI is the most serious type of heart attack and is caused by a complete blockage of the coronary artery.

As a result, blood supply to the heart can be interrupted and cause extensive damage to the heart.

Reports have claimed that women may be at a greater risk of death due to the fact they are often older when they suffer from this kind of heart attack.

On average, they also have a larger number of other conditions than men and less women use stents to open blocked arteries.

The new study compared how premenopausal and postmenopausal women were affected by STEMI in the short and long term.

The researchers looked at patients who were admitted with STEMI and treated with percutaneous coronary intervention (PCI) within 48 hours of symptoms onset between 2010 and 2015.

PCI is a non-surgical procedure done to fix blockages in the coronary artery and restore blood flow to the heart.

The team recorded how many people died 30 days after their treatment, how many died five years after and how many had another cardiovascular event five years on.

Study author Dr. Mariana Martinho, from the Hospital Garcia de Orta in Almada, Portugal, said: “Women of all ages who experience a myocardial infarction are at particularly high risk of a poor prognosis.

“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 living.”

Out of the 884 patients studied, the average age was 62-years-old, and 27 percent were women.

Thirty days after suffering a heart attack, 11.8 percent of women died compared to 4.6 percent of men.

At five years, nearly one-third of women, 32.1 percent, had died versus 16.9 percent of men.

More than one-third of women, 34.2 percent, experienced a major cardiovascular event within five years compared with 19.8 percent of men.

Martinho said: “Women had a two to three times higher likelihood of adverse outcomes than men in the short- and long-term even after adjusting for other conditions and despite receiving PCI within the same timeframe as men.”

The researchers went further and matched men and women according to risk factors for cardiovascular disease, including high blood pressure, diabetes, high cholesterol and smoking.

Adverse outcomes were then compared between matched men and women aged 55 and under and between matched men and women over 55-years-old.

There were 435 patients in this analysis. In matched patients over 55, all adverse outcomes measured were more common in women than men.

Of the women, 11.3 percent died within 30 days compared with three percent of men.

At five years, one-third of women, 32.9 percent, had died compared with 15.8 percent of men.

And more than one-third of women, 34.1 percent, had experienced a major cardiovascular event compared with 17.6 percent of men.

In matched patients aged 55 years and below, one in five women experienced a major cardiovascular event within five years, compared to 5.8 percent of men.

However, there was no difference between the number of women and men who died 30 days or five years after the incident.

Martinho said: “Postmenopausal women had worse short- and long-term outcomes after myocardial infarction than men of similar age.

“Premenopausal women had similar short-term mortality but a poorer prognosis in the long-term 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 men.”

In the study, women were older than men, with the average age for women being 67, while men had an average age of 60.

Women also had higher rates of high blood pressure, diabetes and prior stroke.
However, men were more likely to be smokers and have coronary artery disease.

The interval between symptoms and treatment with PCI did not differ between men and women overall, but women aged 55 and below had a significantly longer treatment delay after arriving at the hospital than their male peers.

Women under 55 waited, on average, for 95 minutes, while men of the same age waited for 80 minutes.

Martinho added: “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 outcomes.”

The research was presented today at Heart Failure 2023, a scientific congress of the European Society of Cardiology.

The event is running between May 20 and 23 in Prague, Czech Republic.