Heart Attack: Young and Female Patients Have Worse Outcomes

Aakriti Gupta, MD, MBBS  Center for Outcomes Research and Evaluation Yale-New Haven Hospital, New Haven, ConnecticutMedicalResearch.com Interview with:
Aakriti Gupta, MD, MBBS
Center for Outcomes Research and Evaluation
Yale-New Haven Hospital,
New Haven, Connecticut

Medical Research: What were the main findings?


Dr. Gupta:
Using a national database, we found that heart attack hospitalization rates for patients under the age of 55 have not declined in the past decade while their Medicare-age counterparts have seen a 20 percent drop.

We also found that among younger patients below 55 years of age, women fare worse because they have longer hospital stays, and are more likely to die in the hospital after a heart attack. Young women were also more likely to have higher prevalence of co-existing medical conditions including diabetes, high blood pressure and higher cholesterol levels. Overall, all patient groups in the study saw increases in these conditions including diabetes and high blood pressure in the past decade.

Medical Research: Were you surprised by the findings?

Dr. Gupta: Yes. It is concerning that hospitalization rates for heart attack in the young have not shown any reduction suggesting that lack of awareness and poorer control of cardiovascular risk factors including diabetes, high blood pressure and smoking may be responsible. Also, young women continue to fare worse in terms of treatment duration and in-hospital mortality. Younger women are a vulnerable yet understudied group with worse cardiac risk profiles and worse outcomes after a heart attack as compared with younger men.

Medical Research: What are the implications?

Dr. Gupta: Physicians and other health care professionals should seek opportunities to inform the patients, public and policy makers about cardiovascular risk factors and direct resources toward younger segments of the population for primary prevention.

Medical Research: What are next steps in the research?

Dr. Gupta: Mechanisms underlying higher risks associated with heart attack in younger women than in men warrant further investigation to identify sex-specific biological, clinical and social factors responsible.

Citation:

Gupta A, Wang Y, Spertus JA, et al. Trends in Acute Myocardial Infarction in Young Patients and Differences by Sex and Race, 2001 to 2010. J Am Coll Cardiol. 2014;64(4):337-345. doi:10.1016/j.jacc.2014.04.054.

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