Women with heart problems are treated differently than men

Women with some cardiac conditions receive less evidence-based treatment than their male counterparts, research published today by the Medical Journal of Australia has confirmed.

Researchers from the University of Sydney, Westmead Hospital and Concord Repatriation General Hospital, assessed differences in the evidence-based treatment received by men and women with non-ST-elevation acute coronary syndromes (NSTEACS) and in their outcomes, both in-hospital and at 6-month follow-up. They also separately assessed these differences in patients with documented coronary artery disease (CAD).

"The proportion of women who underwent cardiac catheterisation was smaller (1710, 71 percent v 4134, 77 percent), and the median time to catheterisation was longer (53 h; IQR, 28–91 h v 47 h; IQR, 25–77 h) than for men; non-obstructive coronary artery disease (NOCAD) was detected in a larger proportion of women than men during catheterisation (602, 35 percent v 566, 14 percent)," they authors, led by Professor David Brieger, Professor of Cardiology at the University of Sydney.

"At discharge, fewer women were prescribed aspirin (85 percent v 91 percent), a second antiplatelet medication (59 percent v 68 percent), beta-blockers (71 percent v 75 percent), or statins (86 percent v 92 percent), or referred to cardiac rehabilitation (54 percent v 63 percent).

"A total of 4676 patients had documented CAD, including 1108 women (24 percent). Smaller proportions of women with CAD than of men underwent coronary artery bypass grafting (110, 10 percent v 563, 16 percent) or were prescribed statins at discharge (94 percent v 96 percent).

"Fewer women than men were referred to cardiac rehabilitation (750, 69 percent v 2652, 75 percent), including of those who had been revascularised (CABG: 97, 77 percent v 509, 83 percent; PCI: 480, 76 percent v 1623, 81 percent)," Brieger and colleagues reported.

"The larger proportion of women with NOCAD may partly explain the difference. However, NOCAD is not a benign condition, and patients can benefit from secondary prevention therapies," they wrote.

"In Australia, adherence to guideline-based therapy for people with NSTEACS could be improved, especially for women in hospital and for both sexes at discharge."