Women are more likely to die early after heart attack than men because they are often not prescribed the drugs they need, according to a new study.
"Female heart attack patients may appear more fragile to physicians since they are often older than men, with smaller bodies and more co-existing conditions, such as diabetes and kidney disease," said study author Claudio Montalto of the University of Pavia in Italy.
"Therefore, doctors might avoid potent anti-platelets (a type of blood thinner) and aggressive blood pressure lowering," Montalto said.
For the study, presented on ACVC Essentials 4U, a scientific platform of the European Society of Cardiology (ESC), the researchers enrolled 1,523 patients, including 471 (31 per cent) women, diagnosed with heart attack between 2015 and 2017.
Prescribed medications as well as medical reasons for not giving certain drugs were recorded. While the rate of in-hospital death was similar between sexes, but after an average 264-day follow-up it was found that more women had died.
"Previous studies had established excess deaths in female heart attack patients, so we expected this result," said Montalto.
A significantly lower number of women received optimal medical therapy at discharge (55 per cent women vs 64 per cent men). Women were also less likely to undergo invasive procedures compared with men (71 per cent women vs 83 per cent men).
"Our study suggests it's not being female that causes more deaths, but receiving fewer recommended drugs. In fact, getting the right medication nearly halves the risk of dying," Montalto said.
The study also collected data on contraindication. A contraindication is a condition or factor that serves as a reason to withhold a certain medical treatment due to the harm that it would cause the patient.
"This enabled us to discriminate whether non-prescription of a drug was due to contraindication or not," he said.
"Appropriate drug prescription is easily improved with increased knowledge of guideline recommendations and closer attention to contraindication to drug therapy. Our study indicates that these actions could improve the outcome of female heart attack patients," Montalto said.