STEMI and coronary artery disease are major but underappreciated killers of Australian women
This issue of the Journal includes confronting data about inequities in the treatment and outcomes for men and women with ST-elevation myocardial infarction (STEMI).1 Khan and colleagues report that the 6-month mortality for women presenting with STEMI is twice that of men, a difference that persists after statistical correction for age and comorbid conditions. The article relates worrying evidence of a disparity in the delivery of evidence-based treatment, raising many important questions: What barriers are preventing women from presenting for treatment earlier? Why are there delays in providing women with recognised life-saving treatments? Why are women as a group treated less intensively than men despite having higher Global Registry of Acute Coronary Events (GRACE) risk scores? What biological differences require distinct therapeutic approaches and dedicated clinical trials?
The full article is accessible to AMA members and paid subscribers. Login to read more or purchase a subscription now.
Please note: institutional and Research4Life access to the MJA is now provided through Wiley Online Library.
- 1. Khan E, Brieger D, Amerena J, et al. Differences in management and outcomes for men and women with ST-elevation myocardial infarction. Med J Aust 2018; 209: 118-123.
- 2. Heart Foundation. 2018. Women and heart disease. 2018. https://www.heartfoundation.org.au/your-heart/women-and-heart-disease (viewed 21 June 2018).
- 3. Wei J, Mehta PK, Grey E, et al. Sex-based differences in quality of care and outcomes in a health system using a standardized STEMI protocol. Am Heart J 2017; 191: 30-36.
- 4. Chew DP, Scott IA, Cullen L, et al. National Heart Foundation of Australia and Cardiac Society of Australia and New Zealand: Australian clinical guidelines for the management of acute coronary syndromes 2016. Med J Aust 2016; 205: 128-133. <MJA full text>
- 5. Bavishi C, Bangalore S, Patel D, et al. Short and long-term mortality in women and men undergoing primary angioplasty: a comprehensive meta-analysis. Int J Cardiol 2015; 198: 123-130.
- 6. Bugiardini R, Ricci B, Cenko E, et al. Delayed care and mortality among women and men with myocardial infarction. J Am Heart Assoc 2017; 6: doi: 10.1161/JAHA.117.005968.
- 7. Zimmermann S, Ruthrof S, Nowak K, et al. Short-term prognosis of contemporary interventional therapy of ST-elevation myocardial infarction: does gender matter? Clin Res Cardiol 2009; 98: 709-715.
- 8. Vaccarino V, Parsons L, Peterson ED, et al. Sex differences in mortality after acute myocardial infarction: changes from 1994 to 2006. Arch Intern Med 2009; 169: 1767-1774.
No relevant disclosures.