Women at Higher Risk of Heart Failure, Death Following First Heart Attack

Women have a 20% increased risk of developing heart failure or dying within 5 years of their first major heart attack compared to men, according to research published in Circulation.

Previous research focused on sex differences and heart health often look at recurrent heart attack or death. However, vulnerability differences to heart failure between men and women remain unclear.

The study included more than 45,000 patients, 30.8% of whom were women hospitalized for a first heart attack between 2002 and 2016. Investigators looked at ST-segment elevation myocardial infraction (STEMI)—which is a severe, life-threatening heart attack—as well as a less severe heart attack known as a non-STEMI (NSTEMI). NSTEMI attacks are more common than STEMI attacks. The average follow-up was 6.2 years.

According to the study, women had a higher rate for the development of heart failure in the hospital or after discharge for both types of heart attack, even after adjusting for certain confounders. Additionally, women had a higher unadjusted rate of death in the hospital than men in both STEMI and NSTEMI attacks.

Of the female patients, 72.8% were seen by a cardiovascular specialist compared with 84% of male patients, according to the study. Women were also prescribed fewer medications, such as beta blockers or cholesterol-lowering drugs. Female patients often tended to be older, with an average age of 72 years of age compared with 61 years of age for men.

"Identifying when and how women may be at higher risk for heart failure after a heart attack can help providers develop more effective approaches for prevention," said lead study author Justin A. Ezekowitz, MBBCh, MSc, a cardiologist and co-director of the Canadian VIGOUR Centre at the University of Alberta in Edmonton, Alberta, Canada, in a press release. "Better adherence to reducing cholesterol, controlling high blood pressure, getting more exercise, eating a healthy diet and stopping smoking, combined with recognition of these problems earlier in life would save thousands of lives of women—and men."

Next steps in the research will focus on whether all patients are receiving the best care, especially female patients.

REFERENCE:

Women found to be at higher risk for heart failure and heart attack death than men [News Release] November 30, 2020; Dallas, TX. Accessed December 2, 2020. https://www.eurekalert.org/pub_releases/2020-11/aha-wft112420.php.