2023-05-22 15:38:34
Women are more than twice as likely to die after a heart attack than men, according to research presented in the Congreso Heart Failure 2023.
“Women of all ages who experience a myocardial infarction are at particularly high risk of a poor prognosis,” says study author Mariana Martinho, from Garcia de Orta Hospital, Almada (Portugal). For this reason, he emphasizes “andThese women need periodic follow-up after their heart attack based on a strict monitoring of blood pressure, cholesterol levels and diabetes, and referral to cardiac rehabilitation.».
Previous studies have found that women with ST-segment elevation myocardial infarction (STEMI) have a worse prognosis during their hospital stay compared with men, and that this may be due to their older age, greater number of other conditions, and fewer use of stents (percutaneous coronary intervention (PCI) to open blocked arteries.
The present study compared short- and long-term outcomes after STEMI in women and men, examining whether any sex differences were evident in both premenopausal (55 years and younger) and postmenopausal (55+ years). 55) women.
This is a retrospective observational study that enrolled consecutive patients admitted with STEMI and treated with PCI within 48 hours of symptom onset between 2010 and 2015.
Adverse outcomes were defined as 30-day all-cause mortality, five-year all-cause mortality, and five major adverse cardiovascular events (MACE; a composite of all-cause death, reinfarction, hospitalization for heart failure, and ischemic stroke) for one year.
The study included 884 patients. The average age was 62 years and 27% were women..
The women were older than the men (mean age 67 vs. 60 years) and had higher rates of high blood pressure, diabetes, and previous stroke. Men were more likely to be smokers and have coronary artery disease.
The data showed that women aged 55 and under had a significantly longer delay in treatment after arriving at hospital than their male peers (95 vs. 80 minutes).
The researchers compared the risk of adverse outcomes between women and men after adjusting for factors that might influence the ratio, such as diabetes, high cholesterol, hypertension, coronary artery disease, heart failure, chronic kidney disease, peripheral arterial disease, stroke, and family history of coronary or artery disease.
Women aged 55 and under had a longer delay in treatment after arriving at hospital than their male counterparts
At 30 days, 11.8% of women had died compared to 4.6% of men. At five years, almost a third of the women (32.1%) had died compared to 16.9% of the men.
“Women were two to three times more likely than men to have short- and long-term adverse outcomes, even after adjusting for other conditions and despite receiving a stent within the same time period as men.”
The researchers conducted a second analysis in which they matched men and women based on risk factors for cardiovascular disease, such as high blood pressure, diabetes, high cholesterol and smoking. Adverse outcomes were then compared between matched men and women aged 55 and under, and between matched men and women aged 55 and over.
There were 435 patients in this matched subanalysis. In those older than 55 years, all measured adverse outcomes were more common in women than in men. Thus, 11.3% of women died within 30 days compared to 3.0% of men. At five years, one third of the women (32.9%) had died compared to 15.8% of the men and more than one third of the women (34.1%) had experienced MACE compared to the 17.6% of men.
A woman does not have to experience the same symptoms as a man when he has a heart attack. In fact, they often present atypical symptoms and late, which makes diagnosis difficult and increases the risk of death. The signs of a heart attack in women are:
Uncomfortable pressure in the chest, sensation of pain in the center of the chest that can last a few minutes, or disappear and appear again.
Pain in one or both arms, back, neck, jaw, or stomach.
Shortness of breath, accompanied or not by chest pain.
Cold sweat, nausea, or dizziness.
As in men, the most common heart attack symptom among women is chest pain or discomfort. The difference is that women are more likely to experience other common symptoms, particularly shortness of breath, nausea, vomiting, and back or jaw pain.
Finally, in matched patients 55 years and younger, one in five women (20.0%) experienced MACE within five years compared with 5.8% of men (HR 3.91), while that there were no differences between women and men in all-cause mortality at 30 days or 5 years.
«Postmenopausal women had worse short- and long-term outcomes after myocardial infarction than men of a similar age. Premenopausal women had similar short-term mortality but a worse long-term prognosis compared with their male counterparts,” she notes.
The findings remind again of the need for greater awareness of the risks of heart disease in women.
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