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When it comes to misbehaving hearts, getting the best possible care and timely treatment can be a matter of life and death.
Unfortunately, it has been shown time and time again that women are not as likely to obtain such care. A new study has reinforced this finding – although women and men have different proportions of types of heart disease, new data shows that women with heart problems are less likely than men with similar conditions to receive treatment. .
“In this study, we evaluated the differences in the evidence-based treatment received by men and women with acute coronary syndromes without ST-segment elevation and in their outcomes (in hospital and at 6 months follow-up) “The University of Sydney Team writes in its new journal.
“We also separately assessed these differences in patients with documented coronary artery disease.”
ST segment elevation refers to the abnormally high profile seen on an EKG that indicates that a heart artery is completely blocked, causing much of the heart muscle to be unable to receive oxygen.
But some heart attacks don’t show up that way on an EKG. These non-ST segment elevation myocardial infarctions (NSTEMI) are often less serious, but can still damage the heart.
Researchers looked at patient registry data from 43 Australian hospitals between February 2009 and October 2018 – finding 7,783 patients with acute coronary syndrome without ST-segment elevation, which they then analyzed during their stay at the hospital. hospital and during a six-month follow-up. .
About 31% of the patients were women, which already shows that more men are ending up in the hospital for these symptoms. But once there, the treatment men and women receive is also slightly different.
“At discharge, fewer women were prescribed aspirin (85 vs. 91%), a second antiplatelet drug (59 vs. 68%), beta-blockers (71 vs. 75%) or statins (86 vs. 92 %), or referred to cardiology. rehabilitation (54 against 63%) “, writes the team.
Although NSTEMI does not show up on an ECG, it causes a rise in the blood of a protein released by damaged heart muscle, while another heart condition called unstable angina (where the heart does not receive enough blood flow). blood and oxygen), does not show this elevation.
But the team also found differences in patients with coronary artery disease more generally – an accumulation of arterial plaque that could ultimately cause a heart attack.
“A total of 4,676 patients had documented coronary artery disease, including 1,108 women. Lower proportions of women with coronary artery disease than men underwent coronary artery bypass surgery (10 vs. 16%) or received statins at the exit (94 against 96%). “
Now, there are reasons for this which are not as bad as they seem at first glance.
Women more frequently have what’s called non-obstructive coronary artery disease – or NOCAD, which is (potentially incorrectly) considered less likely to cause a heart attack, which could explain some of the differences in treatment.
“The women with acute coronary syndromes without ST-segment elevation in our study received less evidence-based treatment, according to previous reports. The greater proportion of women with NOCAD may partly explain the difference,” writes l ‘team.
“However, NOCAD is not a mild disease and patients may benefit from secondary prevention therapies. In Australia, adherence to guideline-based therapy for people with acute coronary syndromes without ST segment elevation may be improved, especially for hospitalized women and for both sexes on discharge. “
The research was published in the Australian Medical Journal.
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