Deadliest Heart Attack Takes Toll on Women
Study: Women Twice as Likely to Die of Most Serious Type of Heart Attack
WebMD News Archive
Dec. 8, 2008 -- Women hospitalized for the most serious type of heart attack are more than twice as likely as men to die, a new study shows.
Researchers examined treatments and outcomes among men and women hospitalized for heart attacks (also referred to as myocardial infarctions) in an effort to determine the extent of widely reported gender disparities.
After adjusting for the fact that the female heart attack patients tended to be older and sicker than the males, the researchers found no overall difference in mortality between the two groups.
But the in-hospital death rate among women who had ST elevation myocardial infarctions (STEMI), which kill more people than any other type of heart attack, was nearly twice that of men -- 10.2% compared with 5.5%. A STEMI-type heart attack is characterized by a specific pattern on an EKG and is usually caused by a sudden, complete blockage of one of the heart arteries.
Many of the deaths occurred in the first 24 hours of hospitalization. During this period, women were less likely than men to receive commonly used treatments such as angiograms and heart bypass surgery.
"There is good news and bad news in our findings," lead author and cardiologist Hani Jneid, MD, of the Baylor College of Medicine, tells WebMD.
"Overall, we are doing a better job than we were a decade ago recognizing and treating heart attacks in women, and mortality rates are better because of this," he says. "But for the most severe type of heart attack, there is still a gap between men and women."
Jneid and colleagues examined the in-hospital medical records of more than 78,000 heart attack patients treated at 420 U.S. hospitals between 2001 and 2006.
On average, the women were eight years older than the men at the time of their heart attacks (age 72 compared to 64), and they were more likely to have heart-related health problems such as diabetes, heart failure, and high blood pressure.
After adjusting for these differences, the researchers found no difference by sex in the overall heart attack death rate, even though women in general got fewer of the recommended treatments than men. Among other findings, women were less likely to receive recommended medications and clot-busting treatments upon arrival at the hospital, and were less likely to undergo immediate angioplasty.
Among the patients who had STEMI events, the increase in death rates in women appeared to be almost entirely related to higher mortality within the initial 24 hours of hospitalization. Although the factors contributing to this are likely multiple, the authors point to the lower use of recommended therapies early during hospitalization as a potential area for improvement in the care of female heart attack patients.
The study appears in the latest issue of Circulation: The Journal of the American Heart Association.