April 22, 2024

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Women more likely than men to die after heart attack

Women more likely than men to die after heart attack


Women more likely than men to die after heart attack.

Women are more than twice as likely as men to die after a heart attack, according to a study presented at the Heart Failure 2023 Congress.

This difference persisted even after controlling for other health factors and duration of treatment, with older women having even higher rates of adverse outcomes.

The reason for this difference remains unknown and requires further research.


Women more likely than men to die after heart attack.



Women are more than twice as likely as men to die after a heart attack, according to research presented  at the European Society of Cardiology (ESC) scientific congress “Heart Failure 2023” on May 23.


Study author Dr Mariana Martinho, of the Garcia de Orta Hospital in Almada, Portugal, said: “Women of all ages who have experienced a myocardial infarction are at particularly high risk of poor prognosis. These women require regular monitoring after a cardiac event and strict Control blood pressure, cholesterol levels and diabetes, and refer to cardiac rehabilitation. Smoking levels are rising among young women and this should be addressed while promoting physical activity and healthy living”.


Previous studies have found that compared with men, women with ST-segment elevation myocardial infarction (STEMI) have poorer outcomes during hospitalization, possibly due to their older age, increased number of other diseases, and fewer Using a stent (percutaneous coronary intervention; PCI) to open a blocked artery. This study compared short- and long-term outcomes after STEMI in women and men, and examined whether there were significant sex differences in premenopausal (55 years and younger) and postmenopausal (55 years and older) women.


This is a retrospective observational study recruiting consecutive patients admitted for STEMI between 2010 and 2015 who underwent PCI within 48 hours of symptom onset. Adverse outcome was defined as 30-day all-cause mortality, five-year all-cause mortality, and five-year major adverse cardiovascular event (MACE; composite of all-cause death, reinfarction, heart failure hospitalization, and ischemic stroke) .


The study included 884 patients. The mean age was 62 years, and 27% were women.

Women were older than men (average age 67 versus 60), and had higher rates of hypertension, diabetes and previous stroke. Men were more likely to be smokers and have coronary artery disease.

Overall, there was no difference between women and men in the time between onset of symptoms and PCI treatment, but women aged 55 years and younger had significantly longer treatment times after arriving at the hospital than their male counterparts (95 minutes vs. 80 minutes) .


The researchers compared women and men after adjusting for factors that could influence the relationship, including diabetes, high cholesterol, high blood pressure, coronary artery disease, heart failure, chronic kidney disease, peripheral artery disease, stroke, and family history of coronary artery disease. risk of adverse outcomes.

When the disease course developed to 30 days, 11.8% of women had died, while only 4.6% of men had died, with a hazard ratio (HR) of 2.76. After five years, nearly a third of women (32.1%) had died, compared with 16.9% of men (HR 2.33). More than a third of women (34.2%) experienced MACE within five years, compared with 19.8% of men (HR 2.10).


“Even after adjusting for other conditions, women were two to three times more likely than men to experience adverse short- and long-term outcomes despite undergoing PCI in the same time frame as men,” said Dr. Martinho.


The researchers performed a further analysis in which they matched men and women based on 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 younger and matched men and women aged 55 and over.


A total of 435 patients were included in the matched analysis. Among matched patients over the age of 55, all adverse outcomes measured were more common in women than in men. About 11.3% of women died within 30 days, compared with 3.0% of men, with a HR of 3.85.

After five years, one third of women (32.9%) died compared to 15.8% of men (HR 2.35), and more than one third of women (34.1%) experienced MACE compared to 17.6% of men (HR 2.15) .

Among matched patients aged 55 years and younger, one in five women (20.0%) experienced a MACE within five years, compared with 5.8% of men (HR 3.91), and in terms of 30-day or five-year all-cause mortality , no difference between females and males.


“Postmenopausal women have poorer short- and long-term outcomes after myocardial infarction than men of a similar age. Premenopausal women have similar short-term mortality rates but poorer long-term outcomes compared with their male counterparts.

Although our The study did not examine the reasons for these differences, but atypical symptoms and genetic predisposition to myocardial infarction in women may play a role.

We did not find any differences between women and men in the use of drugs that lower blood pressure or blood lipid levels.”


She concluded: “These findings are yet another reminder of the need for increased awareness of heart disease risk in women. More research is needed to understand why there are sex differences in outcomes after myocardial infarction so that steps can be taken to close the gap in outcomes”.







Women more likely than men to die after heart attack

(source:internet, reference only)

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