Studies Find Diabetic Women Have Higher Risk of MI, More Likely to Suffer From ACS

New research show that diabetic women "are more at risk than diabetic men of having a heart attack and other complications as they age," according to a study presented Sept. 15 during the European Association for the Study of Diabetes in Stockholm.

The retrospective follow-up study looked at a cohort of diabetic patients living in the Tuscany region of Italy from 2005 to 2012, and compared the effect of age on diabetes-related excess risk of hospitalization for acute myocardial infarction (AMI), ischemic stroke and congestive heart failure (CHF) in men vs. women.

Results showed that in a total of 3,192,203 inhabitants aged more than 16 years (47 percent males), there were 24,605 hospitalization for AMI (16,251 in men and 8,354 in women), 26,953 for ischemic stroke (14,848 in men and 12,105 in women), and 17,628 for CHF (8,403 in men and 9,225 in women).

After adjusting for age, the diabetes-related excess risk was, overall, "significantly higher in women than in men hospitalized for AMI (2.63 times increased risk vs. 1.96 times for men, giving a relative increased risk of 34 percent in women)." However, the increased risk was overall similar between men vs. women for ischemic stroke and CHF.

The authors conclude that, "the risk for heart attack is different to that from the risk of stroke or CHF: both stroke and CHF appear on average later in the life than heart attacks, at a time when the risk associated with diabetes becomes smaller and smaller, thus gender difference in diabetes linked excess risk is smaller for ischemic stroke and CHF."

Meanwhile, a separate study also presented Sept. 15 during the European Association for the Study of Diabetes in Stockholm, found that diabetic women are about 40 percent more likely to suffer acute coronary syndromes than diabetic men.

The study was led by Xue Dong, MD, the Affiliated ZhongDa Hospital of Southeast University, Nanjing, China, and was a systematic review and meta-analysis of 19 studies containing almost 11 million patients.

The authors searched PubMed, Embase, and Cochrane Library databases for both case-control and cohort studies published between 1966 and 2014. A total of nine case-control and 10 cohort studies were included, with data for 10,856,279 individuals and at least 106,703 fatal and non-fatal acute coronary syndrome events.

Results showed "the pooled maximum-adjusted relative risk of acute coronary syndrome associated with diabetes was 2.46 in women and 1.68 in men. In patients with diabetes, women therefore had a significantly greater risk of acute coronary syndrome, with a 38 percent increased risk for women."

The authors conclude that moving forward, "We should avoid sexual prejudice in cardiovascular disease, take all necessary steps to diagnose it early, and control risk factors comprehensively to guarantee the most suitable treatments and best possible outcomes in female patients."

Clinical Topics: Acute Coronary Syndromes, Diabetes and Cardiometabolic Disease, Heart Failure and Cardiomyopathies, Acute Heart Failure

Keywords: Acute Coronary Syndrome, China, Cohort Studies, Diabetes Mellitus, Lipoatrophic, Female, Heart Failure, Hospitalization, Myocardial Infarction, Retrospective Studies, Risk, Risk Factors

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