New Delhi: In a new study of young heart attack victims in Ontario, Canada, researchers found that the health care system provides good quality treatment for young heart attack survivors; Nevertheless, there are significant differences between men and women.
Young women have higher rates of cardiovascular and all-cause hospitalizations than younger men. As the risk factors for heart disease in young women continue to rise, this highlights the importance of continued efforts to strengthen preventive techniques. Their findings were published in Elsevier’s Canadian Journal of Cardiology.
Despite improvements in the management and outcomes of patients with ischemic heart disease, a large number of women are hospitalized annually with acute myocardial infarction (AMI). Several prior studies have found that women have worse outcomes than men after a heart attack. Young women were found to be at particularly high risk, with a much higher mortality rate than younger men, and worse outcomes than older women. As a result, vigorous efforts to address these treatment disparities were aimed at the public and healthcare providers.
“Many care gaps are closing for young women with AMI in Ontario, but readmission rates remain higher than for younger men,” said principal investigator Meena Madan, MD, MHS, Schulich Heart Center, Sunnybrook Health Sciences Center. , and the Department of Medicine, University explained. Toronto, Toronto, ON, Canada.
Using ICES data, investigators studied clinical outcomes in 38,071 heart attack survivors aged 18 to 55 who were treated in Ontario, Canada, between April 1, 2009, and March 31, 2019. Was admitted to the hospital with a diagnosis of AMI. Of these, 8,077 (21.2%) were women. They compared trends in cardiovascular risk factors, angiographic findings and revascularization rates in men and women and studied their outcomes during the first year after a heart attack.
The researchers found that young women hospitalized with AMI had a significantly higher prevalence of cardiovascular risk factors and comorbidities than younger men with AMI. Notably, there was a steady increase in the prevalence of diabetes among women over time. Close to 25% had diabetes in 2009, up from close to 35% in 2018, much higher than men whose rates of diabetes increased only 4% from 18% to 22% in the same period. As of 2018, one in three young women with an AMI had diabetes, nearly half had high blood pressure and dyslipidemia, and more than two in five were current smokers. Although earlier studies found that women were less frequently referred for coronary angiography to evaluate blockages in the blood supply to the heart, by 2018 the use of coronary angiography was largely universal for both sexes. Younger women were less frequently referred for angioplasty or bypass surgery than younger men, which may be explained by the greater prevalence of normal coronary arteries and non-obstructive coronary artery disease observed during angiography in women.
During the study period, the adjusted mortality rate was similar for young men and women after hospitalization for a heart attack. However, the rehabilitation rate for adverse cardiovascular events and the all-cause readmission rate were significantly higher for women (25.8% for women versus 21.1% for men). Young men or women support the notion that young women may benefit from earlier follow-up care and better support networks that may reduce the need to readjust soon after discharge,” Dr. Madan said.
In an accompanying editorial, lead author Karin H. Humphries, MBA, DSc, University of British Columbia, Faculty of Medicine, Vancouver, BC, Canada, comments, “This critical analysis presents us with both good news and bad news. While This provides evidence that the gender gap in AMI is narrowing; there is also an urgent need to understand what drives higher readmission rates among women. Whether it is unrecognized depression, low use of evidence-based medication after AMI, or access. The reason for the delay in care? These areas of investigation clearly need more attention.”
“There is certainly room to do better,” agrees Dr. Madan, “by taking steps that can reduce early readmission rates for young women and the importance of diet, exercise and healthy lifestyle choices to avoid developing May renew public education initiatives to raise awareness about cardiovascular disease.”