NIH-supported findings identify risk factors in women and suggest the need for closer monitoring.
A study funded by the National Institutes of Health shows that women age 55 and younger are nearly twice as likely to be rehospitalized within a year of a heart attack compared to men in same age This is possibly due to the higher rate of risk factors such as obesity, heart failure, depression, and low-income level. The study calls for closer follow-up and further research to improve women’s health outcomes after discharge.
Women ages 55 and younger have nearly double the risk of rehospitalization in the year immediately after a heart attack compared to men of a similar age, according to a study supported by the National Institutes of Health. Higher rates of risk factors such as obesity, heart failure, and depression among women likely contributed to the difference.
The findings suggest a need for closer monitoring of the health of the approximately 40,000 American women aged 18 to 55 years who have heart attacks each year after hospital discharge, and a better -understand the reasons behind different results. The study, funded by the National Heart, Lung, and Blood Institute (NHLBI), part of the NIH, was published today in Journal of the American College of Cardiology.
“We show for the first time that rehospitalizations following heart attacks in women aged 55 and younger are accompanied by several non-cardiac factors, such as depression and low income, that appear which is more common in women than men and is associated with worse side effects. outcomes,” said corresponding author Harlan M. Krumholz, MD, a cardiologist and professor of medicine at Yale School of Medicine, New Haven, Connecticut. He is also the director of the Center for Outcomes Research and Evaluation (CORE) of school. “The study highlights the need for paying more attention to these non-cardiac risk factors in younger women to help design better clinical interventions and improve outcomes after going out for a heart attack.”
“Further study of these risk factors may allow doctors and their patients to focus on ways to help improve a woman’s health after hospital discharge,” said Yuan Lu, Sc. .D., principal investigator of the study, a CORE investigator, and an assistant professor at the Yale School of Medicine.
Researchers have known for some time that women aged 55 years and younger have about twice the risk of dying in the hospital from a heart attack than men of the same age. However, it is not clear whether women also experience an increased risk of cardiovascular and non-cardiovascular complications one year after leaving the hospital following treatment for a heart attack.
To find out more, the researchers analyzed data from the NHLBI’s VIRGO (Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients), which looked at a wide range of risk factors associated with outcomes in those women and men who have had a heart attack. The study included 2,979 patients – 2,007 women and 972 men – at 103 US hospitals. Participants were an average age of 48 years and from ethnically and racially diverse populations.
The analysis showed that almost 30% of these patients were re-hospitalized in the year after the first discharge from the hospital following a heart attack. Most of those revisits peaked within the first month of the patient’s discharge, then slowly declined over the following months. The researchers found that women had almost twice the risk (1.65 times higher risk) of rehospitalization than men.
For men and women, coronary-related complications — those like heart attacks and angina related to blood vessel blockage — are the leading cause of rehospitalization. However, the rate of coronary-related complications for women is about 1.5 times higher than for men – driven in large part by risk factors such as obesity and diabetes.
The largest gender difference appeared in non-cardiac rehospitalizations, which were more than twice as high (or 2.10 times higher) in women than in men. These are hospitalizations caused by events unrelated to heart disease or stroke, such as digestive problems, depression, bleeding, and pneumonia.
The reasons behind this higher non-cardiac rate are unclear, but the researchers found a higher percentage of women than men who were likely to identify as low-income (48% vs. 31% ) and had a higher history of depression (49% vs. 24%) . Although low income is not a medical measure, it is often associated with poor health status due to limited access to health care. The risk for depression is known to increase after a heart attack and may be a risk factor in higher hospitalization rates due in part to undertreatment of the condition in women. However, further studies will be needed to further explore how these factors affect different hospitalizations after a heart attack.
“Future research on non-cardiac risk factors after hospital discharge following a heart attack may lead to the development of targeted strategies that may narrow this equity gap,” said Gina S. Wei, MD, MPH, associate director of NHLBI’s Division of Cardiovascular Sciences and NHLBI’s senior scientific advisor on women’s health. “We look forward to more studies in this area.”
Reference: “Gender Differences in Outcomes of Acute Myocardial Infarction in Young Patients” by Mitsuaki Sawano MD, PhD, Yuan Lu ScD, César Caraballo MD, Shiwani Mahajan MBBS, MHS, Rachel Dreyer PhD, Judith H. Lichtman PhD, MPH , Gail D’ Onofrio MD, MS, Erica Spatz MD, MHS, Rohan Khera MD, MS, Oyere Onuma MD, MSc, Karthik Murugiah MBBS, John A. Spertus MD, MPH and Harlan M. Krumholz MD, SM, 1 May 2023 , Journal of the American College of Cardiology.
This study was supported by grant R01HL081153 from the National Heart, Lung, and Blood Institute and used data from the VIRGO study (NCT00597922).