Medical researchers have noted that younger women who suffer heart
attacks are more likely to die in the hospital than their male counterparts.
Now theres evidence that younger women are also about three
times more likely than men to die in the hospital following a procedure
often performed to prevent heart attacks: bypass surgery.
Thats the conclusion reached by a team of Emory researchers
whose findings will be published in the March issue of Circulation:
Journal of the American Heart Association. The research findings
are available now in the online version of Circulation, located
The difference between women and men is particularly striking
in those younger than age 60, said lead author Viola Vaccarino,
associate professor of cardiology in the School of Medicine and
associate professor of epidemiology in the Rollins School of Public
The Emory scientists reviewed records of 51,187 patients15,178
(29.7 percent) of them womenin the National Cardiovascular
Network database who underwent bypass surgery at 23 medical centers
between October 1993 and December 1999. The patients were divided
into five age groups: younger than 50, 5059, 6069, 7079
and 80 and older. In patients aged 5059, women had double
the risk of in-hospital death following bypass surgery as men. In
patients younger than 50, mortality rates were three times higher
among women than men.
We initially thought the higher prevalence of coexisting
conditions might be responsible for the higher rates of in-hospital
complications and death in younger women, Vaccarino said.
For example, diabetes and renal insufficiency were both much
more common in women than in men in this age group. However, we
concluded that additional health problems and heart disease risk
factors accounted for less than 30 percent of the mortality differences
between young women and men undergoing bypass.
In fact, she continued, women in all age groups
had less severe coronary atherosclerosis, their hearts had better
pumping strength and fewer had already suffered heart attacks than
their male counterparts. So far, weve been unable to determine
what was responsible for the mortality difference between young
men and women in this study. Clearly, further investigation is needed
to find out what factor or factors are responsible.
Coronary artery bypass surgery, which reroutes blood around clogged
arteries to improve the supply of blood and oxygen to the heart,
is performed about 571,000 times annually in the United States.
Approximately 182,000 women undergo bypass surgery each year.