PRAGUE, Czech Republic — Women are twice as likely to die following a heart attack compared to men, a recent study warns. Prior research has shown that women suffering from ST-elevation myocardial infarction (STEMI) — the most severe form of heart attack resulting from a complete blockage of the coronary artery — have poorer outcomes during hospitalization than men.
This discrepancy is attributed to several factors, including women experiencing heart attacks at an older age and having more coexisting health conditions. Moreover, fewer women undergo stent procedures to unblock arteries.
The latest research compared the short and long-term effects of STEMI on pre and post-menopausal women. The study included patients admitted with STEMI and treated with percutaneous coronary intervention (PCI), a non-surgical procedure to rectify blockages in the coronary artery and restore heart blood flow, within 48 hours of symptom onset between 2010 and 2015. Researchers recorded mortality at 30 days and five years post-treatment, along with the occurrence of another cardiovascular event within five years.
“Women of all ages who experience a myocardial infarction are at particularly high risk of a poor prognosis,” says Dr. Mariana Martinho from Hospital Garcia de Orta in Almada, Portugal, in a media release. “These women need regular monitoring after their heart event, with strict control of blood pressure, cholesterol levels, and diabetes, and referral to cardiac rehabilitation.”
Among the 884 patients involved in the study, the average age was 62, with women constituting 27 percent of the participants. Compared to men, women showed higher mortality rates 30 days and five years post-heart attack, along with a higher incidence of major cardiovascular events within five years.
“Women had a two to three times higher likelihood of adverse outcomes than men in the short- and long-term even after adjusting for other conditions and despite receiving PCI within the same timeframe as men,” adds Dr. Martinho.
The researchers further examined men and women with comparable cardiovascular disease risk factors such as high blood pressure, diabetes, high cholesterol, and smoking. This analysis revealed that adverse outcomes were more common in women over 55. Meanwhile, women 55 years and under experienced more major cardiovascular events within five years compared to their male counterparts.
“Postmenopausal women had worse short- and long-term outcomes after myocardial infarction than men of similar age,” Dr. Martinho elaborates. “Premenopausal women had similar short-term mortality but a poorer prognosis in the long-term compared with their male counterparts.”
In the study, women were typically older than men, with average ages of 67 and 60, respectively. Women had higher incidences of high blood pressure, diabetes, and prior strokes, while men were more likely to be smokers and have coronary artery disease.
“The findings are another reminder of the need for greater awareness of the risks of heart disease in women. More research is required to understand why there is gender disparity in prognosis after myocardial infarction so that steps can be taken to close the gap in outcomes,” concludes Dr. Martinho.
The research was presented at Heart Failure 2023, a scientific congress of the European Society of Cardiology held in Prague, Czech Republic.
Key to a strong heart could be strong legs
At the same conference, fellow researchers revealed a possible way to keep a heart attack from leading to even further damage. Researchers working with the European Society of Cardiology reported that patients with especially strong legs are less likely to develop heart failure following a heart attack.
The research team specifically analyzed the association between quadriceps strength (low vs. high) and heart failure risk. In comparison to low quadriceps strength, a high strength level displayed a connection to a 41-percent lower risk of heart failure. Study authors also analyzed the association between quadriceps strength as a continuous variable and the risk of heart failure. They found that each five percent body weight increment in quadriceps strength was associated with an 11-percent lower chance of heart failure.
“Quadriceps strength is easy and simple to measure accurately in clinical practice. Our study indicates that quadriceps strength could help to identify patients at a higher risk of developing heart failure after myocardial infarction who could then receive more intense surveillance,” says study author Kensuke Ueno, a physical therapist at the Kitasato University Graduate School of Medical Sciences, in a media release.
South West News Service writer Mark Waghorn contributed to this report.