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Women More Likely to Die After Heart Attack
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Study Suggests Women Aren't Treated as Aggressively as Men Who Have Heart Attacks
By Charlene Laino
Reviewed by Laura J. Martin, MD
March 16, 2010 (Atlanta) -- Better heart treatment of women could help close the gender gap in heart deaths. Women would be more likely to survive a heart attack if they were treated more like men, French researchers say.
In a study of more than 3,500 people admitted to the hospital for a heart attack, women were far less likely than men to get angiography to visualize heart artery blockages or angioplasty to open up blocked arteries.
Women were about twice as likely to die within a month of having the heart attack, according to the study, presented at the American College of Cardiology's annual meeting.
The higher death rate in women "is related to the fact that they don't get the same treatments as men," says Maria Rosa Costanzo, MD, an American Heart Association spokeswoman who was not involved with the study.
"If women had the same access to procedures and medication as men, they would derive the same benefit," says Costanzo, of Midwest Heart Specialists in Naperville, Ill.
Study researcher Francois Schiele, MD, chief cardiologist at the University Hospital of Besancon in France, says that when possible, "women should be treated with all recommended strategies, including invasive ones."
Closing the Gender Gap
Costanzo tells WebMD that it's been known for some time that women fare worse after a heart attack than men, but it's been unclear why. Some studies point to biological differences such as women's smaller blood vessels that raise the risk of complications during angioplasty, she says.
Also, women tend to be older and have poorer overall health when they have heart attacks, and wait longer to seek medical care than men, research suggests.
But other studies suggest that women are undertreated, Costanzo says.
The new study attempted to level the playing ground by using statistical techniques that took into account women's and men's different characteristics and treatments when they had heart attacks.
The researchers analyzed data from a regional registry that included more than 3,500 patients, about a third of whom were women, treated for a heart attack between January 2006 and December 2007.
Women were, on average, nine years older than men, had more health problems, and received fewer effective treatments for heart attack. They were nearly twice as likely to die, both during the initial hospital stay and over the following month.
When the analysis was adjusted to take into account the differences in the women's ages, blood pressure, kidney function, and other characteristics as well as the treatments they received, there was no difference in death rates, either in the hospital or at 30 days.
"Once they compared apples to apples, it shows women get the same benefit from [procedures to open blocked arteries] and medication as men," Costanzo says.
Drugmakers GlaxoSmithKline, Novartis, and Sanofi-Aventis helped fund the registry.