Men Received Faster Treatment for Heart Attack

Younger men received treatment for heart attack sooner than women in emergency rooms

(RxWiki News) Getting help fast is key to surviving a heart attack, but one new study suggests there may be a delay in getting women the treatment they need once they arrive for emergency care.

The researchers found that more than half of men and women did not receive an electrocardiogram (ECG) to help identify heart-related problems within the recommended time.

The data also revealed a delay for women in receiving medication to dissolve life-threatening blood clots that can stop or slow blood flow to parts of the heart muscle.

"Seek immediate medical attention at the first sign of a heart attack."

This study was led by Louise Pilote, MD, PhD, from Division of Clinical Epidemiology at the Research Institute of McGill University Health Centre and professor of medicine at McGill University.

This research team looked at 1,123 patients between the ages of 18 and 55 who had been admitted the hospital for acute coronary syndrome. The patients were recruited from one of 24 centers in Canada, one from the United States and one from Switzerland.

According to the authors, acute coronary syndrome covers a range of conditions that cause a restriction of blood flow to the heart, including myocardial infarction (heart attack).

This study included 362 women and 761 men, with an average age of 50 for the women and 49 for the men.

These participants completed a survey within 24 hours of hospital admission that asked about responsibility for housework, education level and health status prior to this incident to help the researchers better understand why sex differences in mortality (death) exist in younger men and women with acute coronary syndrome.

This study showed that compared to the men, the women came from lower income brackets and had substantially higher levels of anxiety and depression. The women also were more likely to have diabetes, high blood pressure and a family history of heart disease.

The researchers found that men were given electrocardiograms (ECGs) and fibrinolysis, a class of medication that helps break up blood clots, more quickly than women.

The data showed that, on average, men received an ECG within 15 minutes of arriving with symptoms, compared with 21 minutes for women. Dr. Pilote and colleagues noted that the current recommendation for such patients to receive an ECG is 10 minutes, but less than half of the participants met that standard.

The research team also found that men averaged 28 minutes from arrival to receiving fibrinolysis treatment, which is just under the 30-minute guideline, but women did not receive this treatment until an average of 36 minutes after arrival.

"Despite efforts by the American Heart Association and other groups to raise awareness of heart disease in women, there still appears to be more work to be done," said Sarah Samaan, MD, cardiologist and physician partner at the Baylor Heart Hospital in Plano, Texas. "It's true that women tend to develop heart disease later in life than men, but that is a generalization, and thousands of women do, in fact, have heart attacks and strokes in their 30s and 40s.

According to Dr. Samaan, "This study highlights the importance of taking women's symptoms seriously, and of acting just as quickly to evaluate a woman's symptoms as a man's. Women can help by recognizing their own risk factors, including hypertension, high cholesterol, diabetes, smoking, and a family history, and sharing this crucial information with first responders."

Dr. Pilote and team wrote, "Patients with anxiety who present to the emergency department with noncardiac chest pain tend to be women, and the prevalence of acute coronary syndrome is lower among young women than among young men. These findings suggest that triage personnel might initially dismiss a cardiac event among young women with anxiety, which would result in a longer door-to-ECG interval."

These researchers determined that patients with multiple risk factors or with less typical symptoms, such as a lack of chest pain, also had longer delays in receiving treatment.

The authors concluded that there is room for improvement in meeting the current established treatment timelines and that more specific management may be required for patients with no chest pain and those with anxiety or multiple risk factors.

These authors acknowledged that their study was limited by the inclusion of only survivors of acute coronary syndrome.

This study was published March 17 in the Canadian Medical Association Journal.

This study was funded by the Heart and Stroke Foundations of Quebec, Nova Scotia, Alberta, Ontario, British Columbia and Yukon and Canada and by the Canadian Institutes of Health Research (CIHR).

The authors disclosed that several members of the team were supported or funded by CIHR.

Review Date: 
March 17, 2014