Mayo study reports on angioplasty

April 28, 1993|By Knight-Ridder News Service

Women who undergo coronary balloon angioplasty have a higher hospital death rate than men, but the difference has more to do with the severity of the disease than any inherent difference in the arteries of men and women, a Mayo Clinic study has found.

The study thus appears to dispel fears that women who undergo angioplasty were at higher risk because of their smaller coronary arteries, but it also raises the question of why women are sicker than men when they undergo the procedure.

One explanation might be a bias in how women are referred for angioplasty, but the difference may also be the result of women feeling symptoms differently than men. Or there may be some other explanation.

"We don't have an answer," said Dr. Malcolm Bell, a cardiologist at the Mayo Clinic, in Rochester, Minn., who headed the study. "We're very interested in that issue, and a number of studies are looking into it."

The issue is important because more than 400,000 angioplasties will be performed in the United States this year, about one-third of them on women.

In the Mayo study, published in today's edition of the Journal of the American Medical Association, researchers studied 3,557 patients, 27 percent of whom were women, who underwent 4,071 angioplasty procedures.

During angioplasty, a balloon-tipped catheter is threaded through an artery in the leg and into the blocked coronary vessel. The balloon is then expanded, widening the blocked vessel and restoring blood flow to the heart.

Mayo researchers found the procedure successful in 85 percent of the women and 86 percent of the men, with an in-hospital mortality rate of 4.2 percent for women and 2.7 percent for men.

While the difference in mortality rates is statistically significant, it should not be overemphasized, Dr. Bell said, because the difference can be explained entirely by the fact that the women had more significant disease and were older than the men when they underwent the procedure.

The women were older, he said, because women develop heart disease later in their lives than do men.

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