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Page: << Prev | 1 | 2 When all risk factors were taken into account, "there was no sex-fixed mortality difference among those with acute coronary syndrome," Berger said.
One difference did emerge from the analysis, he said: "Not all acute coronary syndromes can be placed in a single category. There were significant differences based on severity of diagnosis."
The 30-day death rate was higher for women than men who suffered a STEMI myocardial infarction, the most severe form of heart attack. For less severe acute coronary syndromes, such as non-STEMI heart attacks and the acute chest pain called unstable angina, the 30-day death rate was significantly lower for women than men.
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The study shows that what physicians call comorbidities -- other illnesses -- play a more important role in determining survival in women than in men, said Dr. Pamela S. Douglas, professor of medicine at Duke University, a member of the research team.
"What we find is that men have a higher mortality from the heart disease event while mortality in women depends more on the heart disease event plus other illnesses," Douglas said.
The finding doesn't mean that women with heart disease should be treated differently than men, but that physicians should remain aware of the importance of other illnesses in women, she said.
A second report in the same issue of the journal described a genetic variant that can limit the effectiveness of Plavix (clopidogrel), the clot-preventing drug that is commonly prescribed after artery-opening angioplasty.
A study led by physicians at the University of Maryland School of Medicine looked at the effect of a gene called CYP2C19 on the activity of platelets, the blood cells involved in clotting, among members of the Old Order Amish community. It found that those who carried one variant of the gene had a significantly lower response to Plavix therapy. Carriers of the gene variant had more than double the incidence of artery blockage or death in the year after angioplasty than noncarriers -- 20.9 percent compared to 10 percent.
The finding could lead to genetic typing to help guide Plavix therapy, the researchers wrote, but they added that "prospective randomized clinical trials will be necessary to determine the efficacy of CYP2C19 genotype-directed therapy in evidence-based clinical decision making."
More information
Advice on heart disease in women is available from the American Heart Association.
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