Women Are Less Likely to Receive Life-Saving Heart Procedures, Study Results Show

They are also at greater risk of death than men when undergoing cardiac procedures, a new analysis shows.

Women are less likely to undergo procedures for heart issues, and those who do receive them are more likely than men to die when in the hospital, according to data that will be presented at the American College of Cardiology’s 71st Annual Scientific Session.

“Men receive more procedures and are less likely to die, whereas women receive fewer procedures and are more likely to die,” Nischit Baral, MD, of McLaren Flint Hospital in Flint, Michigan, said in a statement.

“In addition, we found that people of color are less likely than those who are white to undergo these procedures. However, our data does not show that people of color are more likely to die following a heart procedure, although the numbers may have been too small to detect this,” Baral said.

Heart procedures, including cardiac stent insertion, heart valve replacements, and pacemaker implantations, are common procedures performed in hospitals and are increasing each year, he said.

However, there are not much data on race- and sex-based differences in the procedure outcomes. Previous studies were limited to differences in outcomes by race and sex for a single procedure, so investigators sought to examine data for the 7 most common procedures.

Investigators examined data from hospitals across the United States between 2016 and 2019, which came from the National Inpatient Sample, a large publicly available database that contains anonymized data from more than 7 million annual hospital stays nationwide.

The type of procedure was then identified by the billing code in the International Classification of Diseases, 10th edition.

More than 2 million hospitalizations for heart procedures were included in the study during the 3-year period. About 62% of all procedures were performed on men and 38% on women.

Compared with men, women receiving these procedures were approximately 3 years older and had slightly higher scores on an index that measured illness severity.

After controlling for factors, including age, hospital location, income, race, severity of illness, and sex, investigators found that women were 13% more likely than men to die in the hospital after a heart procedure.

Regardless of sex, 77% of individuals receiving heart procedures were white compared with 9.6% who were Black, 7.4% who were Hispanic, and 2.4%, who were Asian-American.

“Our findings should be a call to action for doctors to be more aware that heart disease may have a different presentation in a woman and to be more vigilant when women present with atypical symptoms that could be a heart attack,” Baral said. “To improve overall outcomes in women, we should also work together to make sure they are getting the proper cardiovascular procedure on time and are treated with the highest standard of care.”.

Heart disease symptoms are frequently atypical in women, which could be why they are receiving procedures later, Baral said.

For example, women are less likely than men to experience chest pain in the body as a symptom of a heart attack and more likely to report pain in the abdomen, arms, back and jaw.

More research is needed to determine whether individuals of different ethnic and racial backgrounds also have elevated death rates when undergoing heart procedures, investigators said.

Reference

Women less likely to receive life-saving heart procedures. News release. EurekAlert. March 23, 2022. Accessed March 29, 2022. https://www.eurekalert.org/news-releases/947176