Heart attack data adds more evidence that women treated differently to men
Heart attack data adds more evidence that women treated differently to men
Large scale study with 1.5 million adults took place in six countries including the United States
Women who are hospitalised for a heart attack are less likely to receive treatment and are more likely to die than men.
That’s according to a new large-scale study of six diverse countries, including the United States.
And while, sex differences in heart attack treatment and outcomes are well documented already, this study adds evidence that this is also consistent across countries.
The findings were from a study funded by the USA’s National Institute on Aging and have been published in Circulation: Cardiovascular Quality and Outcomes.
How the study worked
Researchers considered both types of heart attack (otherwise known as acute myocardial infarction) - an ST-segment elevation myocardial infarction (STEMI) which creates a longer interruption to the heart’s blood supply, and a non-ST-segment elevation myocardial infarction (NSTEMI) creates some loss of blood supply and a less severe form of heart attack than STEMI.
In both these instances they are medical emergencies that require hospitalisation and treatment and may result in death. Treatments include cardiac catheterization, percutaneous coronary intervention (PCI), and coronary artery bypass grafting (CABG).
Researchers from the University of Texas; Harvard Medical School; University of Manitoba, Canada; and other collaborative institutions examined whether sex differences in older adults hospitalised for a heart attack were consistent across countries with advanced health systems.
Using administrative data from the International Health Systems Research Collaborative, they identified more than 1.5 million adults age 66 years and older who had been hospitalized with a primary diagnosis of STEMI or NSTEMI between 2011 and 2018 in the U.S., Canada, England, Netherlands, Taiwan, and Israel. The researchers looked at hospitalization, treatment, and mortality data in each country, comparing women and men.
Hospitalisations for heart attacks decreased in all countries from 2011 to 2018, with a steeper decline observed among women compared to men. While fewer than half of patients hospitalised were women across nearly all countries and years studied, the proportion was highest in the U.S. for both STEMI (47.5% in 2011 and 42% in 2018) and for NSTEMI (50.7% and 46.9%).
The researchers also found the hospitalized women were less likely than men to receive crucial treatments — cardiac catheterization, PCI, CABG — and had higher rates of death for STEMI than men in most countries but lower rates of death for NSTEMI.
Where to next: using the sex disparities data from the study
Further investigation into what factors may be contributing to these sex disparities could point to pathways for intervention.
Limitations of the current study include use of administrative data, which lacks detailed clinical information, and counting only inpatient treatment, which may underestimate rates of catheterisation and PCI in locations where outpatient treatment is common.