08/04/2021 at 5:09 PM #33623Anonymous UserParticipant
Acute Myocardial Infarction: Significant Treatment Differences Between the Sexes
Women are regularly underrepresented in large medical studies. As a result, gender-specific characteristics of a disease are often poorly known and women are neglected in treatment. This was already shown in a British study on heart attacks in 2019. The GenderVasc project now wants to make these differences public in Germany as well. The aim is to improve care in the field of cardiovascular medicine for all people and to adapt it more individually to the person.
Large data analysis shows: fewer and fewer heart attacks
For this project, researchers evaluated data from 760,000 inpatients with heart attacks. They recently published the results in the “European Heart Journal”. A basic distinction was made between infarcts with and without ST segment elevation. The study counted 280,000 cases with elevation, so-called STEMIs. With them you can see clear signs in the electrocardiogram (EKG) and usually the familiar symptoms of a heart attack occur: severe pain in the chest, an oppressive feeling and shortness of breath. With NSTEMIs, however, the symptoms are often untypical and milder. The Federal Statistical Office recorded 560,000 cases of this type of heart attack. The evaluation of the data showed good news: The number of cases of ST elevation myocardial infarction decreased continuously over the observed period from 2014 to 2017.
Differences between men and women
There were clear gender differences in the frequency of the disease: 70 percent of STEMI patients were assigned to the male gender. In addition, the men receiving treatment for a heart attack were, on average, younger than the women affected. There were also more smokers and patients with high cholesterol levels among the men. In contrast, patients more often brought with them accompanying diseases such as kidney failure, diabetes, heart failure or atrial fibrillation.
Women are operated on less often
However, there were not only differences in the patient groups, but also in their treatment: interventional interventions to open the closed vessels of the heart through a catheter were carried out much more frequently in men than in women. Female patients also received bypass operations less often than their male counterparts. There was also a difference in death rates: women with STEMIs died in hospital in 15 percent of the cases, while this only occurred in 9.6 percent of the cases in the male group. Fewer people died from NSTEMIs in both patient groups, but women still more frequently.
Further research into the causes is needed
The researchers point out that these drastic numbers can be explained on the one hand by the older age and the more frequent comorbidities in women. On the other hand, these are also influenced by the fact that patients are significantly less likely to receive rescue interventions. What causes these differences and how they can be reduced remains to be explored. “Further studies are necessary in order to collect further results and then to convert project results into guidelines and recommendations and to process them in information materials for doctors and patients. In the long term, the project can help ensure needs-based medical care for patients with cardiovascular disease, ”write study authors Leonie Kühnemund and Dr. Eva Freisinger.
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