Women generally have a lower risk of myocardial infarction (MI), coronary heart disease (CHD), heart failure and all-cause mortality than men, however, this female advantage may be reduced following an MI, according to a study published Oct. 5 in the Journal of the American College of Cardiology.

Sanne A.E. Peters, PhD, et al., analyzed data for 171,897 women and 167,993 men age 21 or older with health insurance in the U.S. who were hospitalized for MI in 2015 or 2016. These patients were frequency matched by age and year to 687,588 women and 671,972 men without CHD.

Results showed that age-standardized rates of MI per 1,000 person-years among those without CHD were 4.5 in women and 5.6 in men without CHD, and 60.2 in women and 59.8 in men with MI. Among those without CHD, CHD rates were 6.3 in women vs. 10.7 in men, while CHD rates among those with MI were 84.5 in women vs. 99.3 in men. All-cause mortality rates among those without CHD were 63.7 in women vs. 59.0 in men, while all-cause mortality rates among those with MI were 311.6 in women vs. 284.5 in men.

"This study highlighted the importance of lowering the risk for recurrent events among both women and men following a MI," the authors conclude.

In an accompanying editorial comment, Nanette K. Wenger, MD, MACC, notes that "[over] the decades, women have been substantially under-represented in the diagnostic and therapeutic randomized clinical trials of coronary heart disease, resulting in a far less robust evidence base for women than for men." Wenger highlights how this disparity still exists, "[despite] serial recommendations for sex-based analyses for information regarding women," and offers recommendations to remediation. These recommendations include "the appreciation by women and their health care team members that the female heart is vulnerable to coronary heart disease, with advocacy for a heart-healthy lifestyle," and more.

Clinical Topics: Cardiovascular Care Team, Heart Failure and Cardiomyopathies, Prevention, Acute Heart Failure

Keywords: Coronary Disease, Myocardial Infarction, Risk Reduction Behavior, Primary Prevention, Insurance, Health, Patient Care Team, Heart Failure

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