An “ST-Elevation Myocardial Infarction,” or STEMI, is a heart attack  where one of the main arteries to the heart – the ones that supply oxygen and blood rich in nutrients – is blocked and the electrocardiogram shows a typical heart attack pattern. It’s usually the end result of coronary heart disease – where fatty substances build up in the arteries around the heart to block them. Make no mistake, a STEMI is life-threatening.

This paper wanted to take a closer look at the way men and women were treated for a STEMI in Australian hospitals. It investigated a large registry of patients from 41 hospitals around Australia, enrolled between February 2009 and May 2016. The authors wanted to see which of the patients received “total revascularisation” – which is a range of different interventions , including having a stent put in or having an artery graft to improve blood flow to the heart. They also analysed which combination of interventions each patient got, how timely the intervention was, if they experienced any major adverse events (like a stroke or death caused by a heart problem), and their mortality six months after admission.

The researchers found that women were less likely to have undergone the right diagnostic testing when they presented to hospital, less likely to receive timely treatment, and less likely to receive total revascularisation. What’s more, when they looked at the six month mortality rate, women died at twice the rate of men.

Implications

The authors of the paper urge more research into how it is that these sex differences occur and how the gap between men and women can be reduced. And for those wondering, the signs of a STEMI include chest pain, shortness of breath and nausea – but they can differ between men and women. Women may be more likely to report non typical symptoms such as back or jaw pain.

Last Reviewed: 23/01/2019

© Norman Swan Medical Communications.



References

Khan, et al. (2018). Differences in management and outcomes for men and women with ST-elevation myocardial infarction. Medical Journal of Australia doi: 10.5694/mja17.01109.