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Girls face better danger for coronary heart failure and coronary heart assault dying than males, examine finds

Women are 20% more likely to develop heart failure or die within five years of their first major heart attack compared to men. This is based on new research published today in the American Heart Association’s flagship journal Circulation.

Previous research on gender differences in heart health has often focused on recurrent heart attacks or deaths. However, the differences in susceptibility to heart failure between men and women after a heart attack remain unclear.

To investigate this gap, the researchers analyzed data from more than 45,000 patients (30.8% women) who were hospitalized for a first heart attack in Alberta, Canada between 2002 and 2016.

They focused on two types of heart attacks: a severe, life-threatening heart attack called ST segment elevation myocardial infarction (STEMI) and a less severe type called non-STEMI or NSTEMI, the latter being more common . The patients were followed for an average of 6.2 years.

Women were older and had a variety of complications and risk factors that might have put them at higher risk of heart failure after a heart attack.

In addition to the increased risk of heart failure in women, the researchers found:

  • A total of 24,737 patients had the less severe form of myocardial infarction (NSTEMI); In this group, 34.3% were women and 65.7% were men.
  • A total of 20,327 patients had STEMI, the more severe myocardial infarction; In this group, 26.5% were women and 73.5% were men.
  • The development of heart failure either in hospital or after discharge remained higher in women than men in both types of heart attack, even after adjusting for certain confounding factors.
  • Women had higher unadjusted in-hospital death rates than men in both the STEMI group (9.4% versus 4.5%) and the NSTEMI group (4.7% versus 2.9%). However, the gap for NSTEMI has decreased significantly after confounder adjustments.
  • Women were an average of 10 years older than men at the time of their heart attack, usually an average of 72 years versus 61 for men.
  • Women also had more complicated medical histories at the time of their heart attack, including high blood pressure, diabetes, atrial fibrillation, and chronic obstructive pulmonary disease, risk factors that can contribute to heart failure.
  • Women were seen in hospital by a cardiovascular specialist less often: 72.8% compared to 84% for men.
  • Regardless of whether the heart attack was severe or less severe, fewer women were prescribed drugs such as beta-blockers or cholesterol-lowering drugs. Women also had slightly lower rates of revascularization to restore blood flow, such as B. Surgical angioplasty.

Knowing when and how women are at higher risk of heart failure after a heart attack can help providers develop more effective approaches to prevention. Better adherence to cholesterol lowering, control of high blood pressure, more exercise, a healthy diet, and smoking cessation combined with recognizing these problems earlier in life would save the lives of thousands of women and men. “

Justin A. Ezekowitz, MBBCh, M.Sc., Study Director and Cardiologist, Co-Director, Canadian VIGOR Center, University of Alberta

Based on these findings, study co-author Padma Kaul, Ph.D., co-director of the Canadian VIGOR center, said the next step is to further investigate whether all patients, especially women, are receiving the best care and where intervention is possible, address supervision.

“Close enough is not good enough,” said Kaul, who is also the Chair of Sex and Gender Studies at the Canadian Institutes for Health Research. “There are gaps in diagnosis, access, quality of care and follow-up care for all patients. Hence, we need to be vigilant, be careful of our own prejudices and those at risk, to make sure we did all we can to do that Best to offer. ” Treatment.”


American Heart Association

Journal reference:

JA Ezekowitz et al. (2020) Is There a Sexual Gap in Surviving Acute Coronary Syndrome or Subsequent Development of Heart Failure? Edition: Journal of the American Heart Association. doi.org/10.1161/CIRCULATIONAHA.120.048015.

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