Angioplasty is more risky for women, study says Ten times more deaths reported

March 09, 1993|By Los Angeles Times

Women who undergo angioplasty -- a common procedure in which a tiny balloon is used to reopen clogged arteries -- are 10 times more likely than men to die in the hospital, according to a study that may renew debate about a possible bias in the treatment of female heart patients.

The study, which appears today in Circulation, a journal published by the American Heart Association, found that long-term survival rates for men and women angioplasty patients were about the same. Yet even after risk factors such as hypertension, diabetes and old age were taken into account, women were still 4 1/2 times more likely to die in the hospital.

Researchers said they could not fully explain the disparity.

"I'm afraid that's the unknown," said Dr Cheryl F. Kelsey, an epidemiologist at the University of Pittsburgh and the lead author of the study. "Other than the risk factors, there may be some other things that we didn't measure, that we don't know about."

The study examined the records of 2,136 patients -- 546 of whom were women -- who underwent angioplasties during 1985 and 1986. The records of these operations, from 16 medical centers across the country, were culled from a registry maintained by the National Heart, Lung and Blood Institute.

Though relatively few of the patients studied died before leaving the hospital, the most striking finding was that of the 18 patients who died 14 were women. Elderly women were particularly at risk; of the 14 women who died, 12 were age 65 or older.

One expert, Dr. Marianne Legato, a Columbia University medical professor, said the study demonstrates that heart disease is being detected later in women than in men.

"I don't think that this is very reassuring," said Dr. Legato, author of "The Female Heart," a recent book on heart disease and women. "I think that we have to pick this disease up in women sooner and treat it aggressively sooner and until we try that . . . I think we are still going to have statistics like this."

The findings add to a body of evidence that women who suffer from heart disease fare worse than men.

Those reports heightened concern about treatment of women and sparked "a movement . . . to compensate for sex bias," according to an editorial accompanying the study published today.

But the cardiologists who wrote the editorial said the new study's findings should put "a sobering caution" on that movement.

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