November 15, 2000
MEDIA CONTACT : Karen Infeld
PHONE: (410)955-1534
E-MAIL: kinfeld@jhmi.edu
Women Less Likely to Get
"Aggressive" Treatment for Vessel Disease
Looking for a clue to the continuing cycle of hospitalizations among men
and women with congestive heart failure (CHF) cased by coronary artery
disease (CAD), Johns Hopkins researchers have observed that women with
ischemic CHF (caused by lack of oxygen to the heart muscle) have a
four-fold increased risk of being readmitted to the hospital due to factors
such as repeated angioplasties, rhythm disturbances and ischemic events.
Zaruhi Babayan, M.D., Ph.D., lead author of the study, says that CAD is
regarded as less prevalent in women: "Women's blood vessels are
smaller,
and it's harder to assess the extent of disease and provide definitive
treatment, so disease is often diagnosed late or is mistreated. Moreover,
as the rate of artery re-narrowing is high after angioplasty, the women who
are preferentially treated with angioplasty rather than bypass surgery
predictably have recurrent hospital readmissions for additional treatment."
Babayan and colleagues studied records from 493 heart failure patients who
presented to the Hopkins Emergency Department, and followed them for
hospital readmission within an average of 16 months to determine the
cause(s) of relapse.
Researchers found that men (7.2 percent) and women (7 percent) hospitalized
for heart failure were equally likely to have been treated before with
angioplasty, but women (8.2 percent) were significantly less likely to have
received bypass surgery than men (18.2 percent).
"Women are more likely to receive angioplasty than bypass surgery,"
says
the study's senior author, Joao A.C. Lima, M.D., director of
echocardiograhy. "But in 10 to 20 percent of angioplasty patients,
the
arteries re-narrow within six months, and those patients wind up back in
the hospital. Our study shows that a history of angioplasty was the main
predictor for hospital readmission for women."
Says Babayan, "These observational data serve as an alert that women with
ischemic heart failure represent the group of patients at high risk for
readmissions due to coronary artery disease and require definitive
revascularization procedures early in the course of disease."
Related links:
American Heart Association 73rd Scientific Sessions
http://www.scientificsessions.org/index.oft
Information on Heart Disease Treatments at Johns Hopkins
http://www.hopkinsmedicine.org/heartdisease.html
