Higher risk of rehospitalization for women under 55 after heart attack
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Higher risk of rehospitalization for women under 55 after heart attack
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Higher risk of rehospitalization for women under 55 after heart attack.
Women 55 and younger have almost twice the risk of being rehospitalized within a year of a heart attack than men of the same age.
Women age 55 and younger are almost twice as likely to be readmitted to the hospital within a year of a heart attack as men of the same age, according to a study supported by the National Institutes of Health.
Risk factors such as obesity, heart failure and depression, which are more prevalent among women, likely account for the difference.
The findings point to the need for closer health monitoring of the approximately 40,000 U.S. women aged 18 to 55 who are discharged from the hospital each year for heart attacks and a better understanding of what lies behind the different outcomes.
The study, funded by the National Heart Lung and Blood Institute (NHLBI), part of the National Institutes of Health, was published today in the Journal of the American College of Cardiology.
Krumholz, MD, a cardiologist and professor of medicine at Yale University School of Medicine in New Haven, Connecticut, said: “Our results show for the first time that readmission after a heart attack in women 55 and younger is associated with a certain Noncardiac factors, such as depression and low income, appear to be more common in women than men and are associated with more adverse outcomes.
He is also director of the University’s Center for Outcomes Research and Evaluation (CORE).” Research reveals the need for greater attention to these noncardiac risk factors in young women to help design better clinical interventions to improve outcomes after heart attack hospital discharge. “
“Further research on these risk factors could allow physicians and their patients to focus on helping to improve women’s health after discharge,” said the study’s principal investigator Yuan Lu, an investigator with CORE and an assistant professor at Yale School of Medicine.
Researchers have known for some time that women aged 55 and younger are about twice as likely to be admitted to the hospital and die from a heart attack than men of the same age.
However, it is unclear whether women also experience a higher risk of cardiovascular and non-cardiovascular complications one year after leaving the hospital after treatment for a heart attack.
To learn more, the researchers analyzed data from the NHLBI’s VIRGO (Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients) study, which looked at a broad range of risk factors associated with outcomes in women and men who had a heart attack .
The study included 2,979 patients — 2,007 women and 972 men — at 103 hospitals in the United States. Participants had an average age of 48 and came from a diverse group of nationalities and races.
Nearly 30 percent of these patients were readmitted within a year of first leaving the hospital after their heart attack, the analysis showed. Most of these rehospitalizations peaked within the first month after discharge and then slowly declined over subsequent months.
The researchers found that women were almost twice as likely to be readmitted to hospital as men (1.65 times the risk).
For both men and women, coronary artery-related complications — those heart attacks and angina associated with clogged blood vessels — were the leading cause of readmission.
However, women have nearly 1.5 times higher rates of coronary artery-related complications than men — driven in large part by risk factors such as obesity and diabetes.
The largest sex differences were seen in non-cardiac readmissions, where women were more than twice as likely (or 2.10 times) as men to be readmitted.
These are hospitalizations caused by events not related to heart disease or stroke, such as digestive problems, depression, bleeding and pneumonia.
The reasons behind these higher rates of non-cardiac hospitalizations are unclear, but the researchers found that women were more likely than men to identify as low-income (48% vs. 31%) and had a higher history of depression (49% vs. 24%).
Although low income is not a medical measure, it is often associated with poor health due to limited access to health care.
The risk of depression is known to increase after a heart attack and may be a risk factor for higher rates of hospitalization, in part because women are undertreated for the condition.
However, further research is needed to further explore how these factors influence different hospitalizations after a heart attack.
Gina S. Wei, MD, MPH, associate director of the NHLBI Division of Cardiovascular Sciences and senior scientific advisor to NHLBI Women’s Health, said: “Future research into noncardiac risk factors for hospital discharge after a heart attack may lead to the development of targeted strategies to to close this equity gap. We look forward to more research in this area.”
Higher risk of rehospitalization for women under 55 after heart attack
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