New research presented at the Heart Failure 2023 congress of the European Society of Cardiology reveals a concerning trend: Women are more than twice as likely to die following a heart attack than men. Dr. Mariana Martinho of Hospital Garcia de Orta in Almada, Portugal, conducted the study, highlighting the urgent need for better monitoring and care for women who have experienced a heart attack.
Dr. Martinho explains that women of all ages who suffer a heart attack are at particularly high risk of poor outcomes. “These women need regular monitoring after their heart event, with strict control of blood pressure, cholesterol levels and diabetes, and referral to cardiac rehabilitation,” she said in a press release. “Smoking levels are rising in young women and this should be tackled, along with promoting physical activity and healthy living.”
Gender Disparities and Factors
Previous studies have indicated that women with ST-elevation myocardial infarction (STEMI) generally have worse outcomes during their hospital stay compared to men. Factors contributing to this include older age, higher prevalence of other health conditions, and lower utilization of stents (percutaneous coronary intervention; PCI) to open blocked arteries.
The study aimed to compare short- and long-term outcomes after STEMI in premenopausal (55 years and under) and postmenopausal (over 55) women, shedding light on potential gender disparities.
The retrospective observational study included 884 patients admitted with STEMI and treated with PCI within 48 hours of symptom onset between 2010 and 2015. Results showed that women, who accounted for 27 percent of the participants, were older than men and had higher rates of high blood pressure, diabetes, and prior stroke. Conversely, men were more likely to be smokers and have coronary artery disease.
Although there was no significant difference in the time interval between symptoms and PCI treatment overall, women aged 55 and below experienced longer treatment delays upon hospital arrival compared to men.
Adverse Outcomes for Women
Even after adjusting for various factors, such as diabetes, high cholesterol, hypertension, coronary artery disease, and other medical conditions, the study found that women faced a two to three times higher likelihood of adverse outcomes compared to men, both in the short- and long-term.
Within 30 days, 11.8 percent of women had died compared to 4.6 percent of men. After five years, nearly one-third of the female participants (32.1 percent) had died, while only 16.9 percent of the men had. Additionally, more than one-third of women (34.2 percent) experienced major adverse cardiovascular events (MACE) within five years, in contrast to 19.8 percent of men.
Dr. Martinho concluded by emphasizing the pressing need for greater awareness of heart disease risks in women. “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.”