An analysis of long-term outcomes after a heart attack shows promising news for premenopausal women, according to new research presented at the European Society of Cardiology. 

Previous studies have found that women are more likely to die after a heart attack than men, according to the authors of the current study. However, this did not seem to apply to premenopausal women because at this stage, women are still exposed to oestrogen, a hormone that protects against heart disease. 

The study authors examined 1778 men and 222 women under the age of 45 who presented to 125 different Italian coronary units between 1998 and 2002. The primary endpoint was a composite of stroke, recurrent heart attack, or death from cardiovascular disease with a median follow-up of 20 years.  

The primary composite endpoint occurred in 25.7% of women, which is much lower than the 37% of men. A second heart attack was also much less frequent in women than in me. A second heart attack occurred in 14.2% of women and 25.4% of men. 

However, women were more likely to have a stroke compared to men, with 7.7% of women experiencing a stroke and 3.7% of men. Men were also much more likely to engage in risky behavior. Nearly half, 46.5% of the male participants. were smokers compared with 42.8% of women. 

Men were also much more likely to be drinkers, as 65.3% of men consumed alcohol compared with 27.4% of women in the study. High blood lipids were present in 62.3% of men versus 50.7% of women. Nearly 8% of male participants had diabetes compared with just 5.4% of female participants. 

After discharge from the hospital, men were more likely than women to be prescribed medication to protect against a second heart attack, such as beta-blockers and aspirin. Statin treatment rates were similar in men and women. 

 "In men, coronary events were mostly due to blocked arteries, while in women they had other causes such as coronary dissection which is known to have a more favorable prognosis and a lower risk of recurrence," Diego Ardissino, MD, principal investigator and professor at Parma University Hospital, Italy, said in the press release. 

Reference:
Study provides hope for young women after heart attack (Press release), Sophia, Antipolis, France August 30, 2020, EurekAlert! Accessed August 31, 2020