Young women have worse heart attack outcomes compared with young men, according to a recent study published in the European Heart Journal.

Compared with men, women under 50 years of age who had suffered a heart attack were less likely to undergo invasive therapeutic procedures after hospital admission. Additionally, they are less likely to be treated with medications such as aspirin, beta blockers, angiotensin-converting enzyme inhibitors, and statins. 

Investigators looked at 404 women and 1693 men who had a first heart attack between 2000 and 2016 and were treated at Brigham and Women’s Hospital and Massachusetts General Hospital. The median age of participants was 45 and 53% of the patients had ST-Elevation myocardial infraction. According to the study, this is a type of heart attack in which there is a long interruption to the blood supply caused by a total blockage of the coronary artery. 

The most common symptom was chest pain, which occurred in almost 90% of the patients. However, women were more likely to have other symptoms, such as difficulty breathing, palpitations and fatigue. 

Over a median follow-up time of 11.2 years, cardiac death occurred in 73 men (4.4%) and 21 women (5.3%). However, when excluding deaths that occurred in the hospital, 157 men (9.5%) and 54 women (13.5%) died from all causes during the follow up period. Of the participants, 8.4% of women and 5.4% of men died of cardiovascular problems. 

"While further studies will be required to evaluate the underlying reasons for these differences, clinicians need to evaluate and, if possible, treat all modifiable risk factors that may affect deaths from both cardiovascular and non-cardiovascular events. This could lead to improved prevention, ideally before, but in some cases, after a heart attack. We plan further research to assess underlying sex-specific risk factors that may account for the higher risk to women in this group, and which may help us understand why they had a heart attack at a young age," study lead Ron Blankstein, MD, said in the press release. 

Limitations of the study included not being able to account for some potential factors that may be associated with patient outcomes and the small number of women in the study may have also affected outcomes, according to the authors. 

Reference:
Young women who suffer a heart attack have worse outcomes than men [News Release] October 13, 2020; Europe. https://www.eurekalert.org/pub_releases/2020-10/esoc-yww100920.php. Accessed October 14, 2020.