Women Undergoing Heart Attack Delay Hospital Arrival

Researchers at the University of Bologna (Italy) examined records of 7,457 European patients enrolled from 2010 to 2014 in an international registry of heart disease and treatments. The researchers found that women were nearly twice as likely to die in the hospital compared with men, with in-hospital deaths reported for 12% of women and 6% of men. Risk of dying remained higher in women even after adjusting for other clinical variables, including age, treatments received, and cardiovascular risk factors.

Analysis revealed that women waited longer to call for help, with more than 70% of women in the study taking longer than an hour to get to a hospital that could treat them, while less than 30% of men took that long. Overall delays ranged from five minutes to three days. Once patients were admitted, there were no significant differences between men and women in time to antithrombotic treatment (26 minutes for men and 28 minutes for women), or balloon angioplasty (45 minutes). The study was presented at the American College of Cardiology (ACC) 64th annual scientific session, held during March 2015 in San Diego (CA, USA).

“The most important factor for worse outcomes for women in his study was the pre-hospital delay. Many delays occurred because women simply waited longer than men to call emergency medical services. Even after calling for help, women seem to disappear somewhere in the health care system,” said lead author professor of cardiology Raffaele Bugiardini, MD. “Our findings should set off an alarm for women, who may not understand their personal risk of heart disease and may take more time to realize they are having a heart attack and need urgent medical help.”

“It is time to look beyond using in-hospital quality initiatives that focus on door-to-balloon or needle time as the only performance measures, especially in women,” added Dr. Bugiardini. “In the last decade, hospitals in the US and other countries have spent a lot of money improving in-hospital time to treatment for heart attack, but nobody considered what happens before they actually get to the hospital. We must take a step back and look at the overall 'time to reperfusion' and find strategies that can favorably impact outcomes in women.”

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University of Bologna