WOMEN'S HEALTH
July 6, 2016

Women's Heart Attacks Dangerously Under-Treated

Women in cardiac arrest are 30% less likely to have an angiogram or angioplasty than men. Now the question is, why?

The calendar may say 2016, but women are still treated differently from men when it comes to cardiac arrest. A new study has found that following cardiac arrest, women are diagnosed and treated less aggressively.

Over the last decade, science has made a lot of progress improving patients’ survival after cardiac arrest, using tools such as angiograms to pinpoint blocked arteries and angioplasties to open them, Luke Kim, lead author on the study, told TheDoctor.

Women with cardiac arrest were 25% less likely to receive an angiogram and 29% less likely to receive angioplasty, or percutaneous coronary intervention, compared to men in cardiac arrest.

“…[E]ven with this tremendous progress, a bit of a gender gap still exists in treating women versus men when they present with cardiac arrest,” said Kim. This gender disparity is surprising, he said, because the decision to use treatments such as therapeutic hypothermia are made by doctors in the hospital, a group for whom outcomes are everything.

The study is the first to report gender disparities across a representative population of cardiac arrest patients at more than 1,000 U.S. hospitals. The researchers analyzed data from more than 1.4 million cases where patients with cardiac arrest were transported to acute care hospitals over a 10-year period. During that time, the number of cardiac arrests increased by 14%.

Women with cardiac arrest were 25% less likely to receive an angiogram; 29% less likely to receive angioplasty, or percutaneous coronary intervention (PCI), compared to men in cardiac arrest; and 19% less likely to receive therapeutic hypothermia, in which body temperature is lowered to improve the odds of survival and decrease the risk of brain damage.

Overall, the women in the study were older than the men, and less likely to have been previously diagnosed with coronary artery disease. They were also more likely to have other health problems such as congestive heart failure, high blood pressure and obesity. Cardiac arrest in women was more likely to be attributable to a cause other than a blocked artery such as pulmonary embolism.

One big factor for improving survival for both sexes is the prompt response from bystanders. Cardiac arrest is one of those medical events where early recognition of symptoms and prompt response by bystanders significantly improves the survival rate, said Kim, an associate professor of medicine at Weill Cornell Medical College in New York City.

“Public awareness needs to increase about how to respond to cardiac arrest, especially in women,” said Kim. If proper CPR is done promptly, survival is significantly improved, versus having nothing done until EMS arrives.

Doctors need to realize women should be treated in the same manner as men. Kim expects that future studies will be done to determine what drives this gender disparity.

The study is published online in the Journal of the American Heart Association.

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