Heart attack care is different for male and female patients—and the inconsistency can lead to fatal results

Women are prescribed fewer drugs after a heart attack than men—and they are more likely to die afterward as a result of that disparity, according to new findings presented on the European Society of Cardiology’s ACVC Essentials 4U platform.

The study involved data from more than 1,500 patients who were diagnosed  with a heart attack between 2015 and 2017. Sixty-nine percent of the patients were men. After an average follow-up period of 264 days, more women had died than men.

Overall, 55% of women received “optimal medical therapy at discharge” compared to 64% of men. In addition, 77% of women underwent invasive procedures compared to 83% of men.

“It is well established that optimal medical therapy and invasive management are both associated with increased survival after myocardial infarction,” author Claudio Montalto, MD, of the University of Pavia in Italy, said in a statement. “Therefore, we then examined whether female patients had worse survival strictly due to their sex—which means genetic and hormonal status, and so on—or because of suboptimal treatment.”

Multivariable regression revealed that receiving optimal care was independently associated with a decrease in all-cause mortality of nearly 50%--the patient’s sex, on the other hands, was not independently associated with such significant decrease or an increase.

“Our study suggests that it is not being female that causes more deaths, but it is receiving fewer recommended drugs,” Montalto added. “In fact, getting the right medication nearly halves the risk of dying.”

And why are women receiving such different care? Montalto did offer a few possibilities, noting that physicians—particularly older male physicians—may view women was “more fragile” or worry more about the impact of any pre-existing conditions.

“Appropriate drug prescription is easily improved with increased knowledge of guideline recommendations and closer attention to contraindications to drug therapy,” Montalto concluded in the statement. “Our study indicates that these actions could improve the outcome of female heart attack patients.”