Heart attacks: are they different for men and women?

While many factors around heart attacks are the same for both men and women, there are several important differences. A 2019 medical journal article by a team of doctors including Dr. Alexandra C. Murphy of Warringal Private Hospital explores some of them.

Comparing men, women, and door-to-balloon time

When comparing differences between male and female patients, the article looked at what is known as door-to-balloon time: the time from when a patient first has contact with medical staff to the time when they receive treatment for their heart attack.

The team of researchers compared women and men presenting with ST-elevation Myocardial Infarction (or STEMI) heart attacks who were treated with a primary percutaneous coronary intervention (PPCI) to see what their long-term mortality rates looked like. STEMI is a life threatening condition and requires urgent medical attention and treatment.

They analysed more than 6000 consecutive patients presenting with STEMI between 2005 and 2017. Of these patients, 20.3% were female.

The study found the female patients were older (a median age of 69 years compared with a median of 62 among men), had more comorbidities, and were more likely to present with high risk features such as renal dysfunction, atrial fibrillation, left ventricular dysfunction and multivessel coronary artery disease.

While the women had more comorbidities, the men were more likely to be current smokers with a personal or family history of coronary artery disease, and were more likely to present with OCHA, or out-of-hospital cardiac arrest.

Women received less treatment and less medication

Overall, the study showed that women had longer median symptom-to-balloon times as well as longer median door-to-balloon times than their male counterparts.

Dr. Murphy and the team also found that women received less guideline-directed treatment for their heart attack. This included less drug-eluting stents, and less radial access for their PPCI. Importantly, they were also prescribed less medication, such as aspirin, statins and beta blockers. All of these factors have the ability to influence recovery and long-term mortality.

Although cardiovascular outcomes have improved over time, women are still more likely to die when presenting with a heart attack.

Where gender was not a factor

Age, left ventricular dysfunction, renal impairment, lung disease, cardiogenic shock, and OHCA at presentation were strong predictors of mortality, as was being a current smoker.

While overall health plays a critical role in protecting yourself against heart attacks, this study shows how societal factors can influence how quickly women will seek treatment, what type of treatment they receive, and whether they continue with rehabilitation following surgery.

If you have any concerns about your health or the health of a loved one, always talk to your primary healthcare provider first.

For more information on Cardiac Care at Warringal Private Hospital, click here.