Women call an ambulance for husbands, fathers and brothers with heart attack symptoms but not for themselves, according to the results of two studies presented at Acute Cardiovascular Care 2019, a European Society of Cardiology (ESC) congress.
Ischaemic heart disease is the leading cause of death in women and men yet the research shows disparities in management the main message of two studies from the Polish Registry of Acute Coronary Syndromes (PL-ACS) was that: 'It’s time for women take care of themselves too.'
Professor Mariusz Gąsior, principal investigator of the registry, said: “Very often women run the house, send children to school, and prepare for family celebrations. We hear over and over again that these responsibilities delay women from calling an ambulance if they experience symptoms of a heart attack.”
A total of 7,582 patients with ST-elevation myocardial infarction (STEMI) were included in the analyses. STEMI is a serious type of heart attack where a major artery supplying blood to the heart is blocked. Faster restoration of blood flow translates into more salvaged heart muscle and less dead tissue, less subsequent heart failure, and a lower risk of death. Guidelines, therefore, recommend opening the artery with a stent within 90 minutes of diagnosis in the ambulance by electrocardiogram (ECG).
Overall, 45% of patients were treated within the recommended timeframe – these patients were less often women. After adjusting for factors that could influence the relationship, male sex remained an independent predictor of treatment within the recommended timeframe.
Patients within and outside the advised treatment window had similar rates of in-hospital mortality, but those treated promptly were less likely to have a left ventricle ejection fraction below 40% – meaning their heart was better able to pump blood and they had a lower chance of developing heart failure.
ECG results were transmitted from the ambulance to a heart attack centre in about 40% of patients. In women, the likelihood of ECG transfer rose with increasing age – from 34% in women aged 54 years and under to 45% in those aged 75 and above. In men, the rate of transfer was around 40% regardless of age.
Professor Gąsior said: “One of the reasons women are less likely than men to be treated within the recommended time period is because they take longer to call an ambulance when they have symptoms – this is especially true for younger women. In addition, ECG results for younger women are less often sent to the heart attack centre, which is recommended to speed up treatment.”
Women are also more likely to have atypical signs and symptoms, which may contribute to a delay in calling for medical assistance.