Statement from the ESC on Gender differences in medical care and survival after myocardial infarction
In Europe results from a Swedish cohort study of 53,781 subjects (of whom 37 per cent were women) also showed that overall women were less intensively treated than men, but, in cases of non-STEMI, had a better long-term prognosis than men.
Commenting for the ESC on the STEMI results in the Circulation paper, Professor Eva Swahn (University Hospital, Linköping, Sweden), who has conducted gender studies in acute coronary syndrome patients, said: "We are not surprised. We found similar results in our Swedish cohort study."
Although the incidence of AMI is low in both sexes, especially in premenopausal women, the view persists - mistakenly - that women don't have the same coronary symptoms as men. "This is a myth," says Professor Swahn. "The classical symptoms of AMI are the same for women as for men." However, this mistaken belief may explain why reperfusion therapy is not started as quickly in women as in men - because women interpret their symptoms differently from men and may not summon help soon enough.
While there are some recurring patterns in the studies - less intensive treatment in women, lower survival rates in female STEMI patients - much of the explanation for the disparities remains unknown. Definite answers about medication, invasive or non-invasive treatment, and survival will only be derived from studies powered to draw significant conclusions in both men and women in the same prospective cohort. And the optimal treatment recommendations for men and women respectively will only be resolved by inclusion of sufficient numbers of both women and men in future clinical trials.
The European Society of Cardiology (ESC):
The ESC represents nearly 53,000 cardiology professionals across Europe and the Mediterranean. Its mission is to reduce the burden of cardiovascular disease in Europe.
The ESC achieves this through a variety of scientific and educational activities including the coordination of: clinical practice guidelines, education courses and initiatives, pan-European surveys on specific disease areas and the ESC Annual Congress, the largest medical meeting in Europe. The ESC also works closely with the European Commission and WHO to improve health policy in the EU.
The ESC comprises 3 Councils, 5 Associations, 19 Working Groups, 50 National Cardiac Societies and an ESC Fellowship Community (Fellow, FESC; Nurse Fellow, NFESC). For more information on ESC Initiatives, Congresses and Constituent Bodies see www.escardio.org.
European Society of Cardiology, The European Heart House 2035 Route des Colles, B.P. 179 - Les Templiers, Sophia Antipolis F-06903 France
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