A new study has found that women who suffer the most severe form of heart attack are twice as likely as men to die in the hospital in the first 24 hours. The authors of the study also reported that women heart attack patients were less likely to receive timely treatment with aspirin or certain heart drugs, therapy to restore blood flow, or angioplasty to open blocked arteries than men.

The study in the medical journal Circulation, which is published by the American Heart Association was undertaken by researchers at the University of California, Los Angeles.

They reviewed data on more than 78,000 people treated for heart attacks at 420 U. S. hospitals between 2001 and 2006. The researchers found no gender gap in deaths for all heart attacks after taking into account differences in risk factors and age but they found that women who suffered STEMI or ST-elevation myocardial infarction, had a
12 % higher risk of dying in the hospital than men .

Study lead author Dr. Hani Jneid, an assistant professor of cardiovascular medicine at Baylor College of Medicine in Houston said, "We believe that a part of it may be related to the fact that women are undertreated. There is evidence across the board of under treatment." Jneid added, "We obviously could not assess the appropriateness of the treatments. But the results point to the fact that there might be some sex-related disparity in treatment that needs to be addressed by physicians."

Dr. Gregg C. Fonarow, a professor of cardiovascular medicine at the University of California, Los Angeles and an author of the study said, "For these types of heart attacks, which are usually caused by complete occlusion of the arteries and where immediate treatment to try and get the artery opened is so important, we still found important differences in early treatment and in outcomes."

He added that "Women when presenting with a heart attack tend to be older and have other comorbid conditions [health problems]. But even when we adjusted for that, we found a 12 percent difference." Previous studies had reported that women were less likely to survive a heart attack as compared to men but many experts disagreed with what could be the cause. Fonarow said, "Women present more atypically," he said. "They are less likely to have sternal chest pain or pressure, just general symptoms like shortness of breath or other symptoms that are non-specific."

The study also found a difference in the treatment given to men and women. They reported that women were 14 % less likely to receive early aspirin, 10 % less likely to be given beta blocker drugs, 25 % less likely to receive reperfusion therapy to restore blood flow, and 13 % less likely to have artery-opening angioplasty within 90 minutes of arrival at the hospital.

Dr. Fonarow said that the data represent an improvement in timely treatment for women since the 1990s. "Overall the gaps in care between men and women have narrowed," he said. "Earlier studies found less than one in 10 patients were receiving balloon angioplasty within 90 minutes and drug infusion within 30 minutes," Dr. Fonarow said. "Here we're seeing two-thirds are getting it."

Dr. Nieca Goldberg, a spokeswoman for the American Heart Association, said, "Part of the reason women fare so badly immediately after a heart attack may be because they delay treatment and have more heart damage. We have to encourage women to be aware of symptoms and go to the hospital. Don't think about it -- call 911." Dr. Laura Wexler, senior associate dean at the University of Cincinnati College of Medicine, and another author of the report said, "I think there are impediments to the diagnosis of coronary disease in women, including, but not exclusively, some lack of appreciation in some sectors of the importance of coronary disease in women."