March 11, 1994
Media Contact: Joann Rodgers
Phone: (410) 955-8659
Women continue to die more often from heart attacks than their male counterparts, but much less so when they receive thrombolytic therapy, says a National Registry headed by a Johns Hopkins physician.
"Several studies have explored the higher mortality rate for women after a heart attack. This analysis goes a step further to examine one of the reasons why," says Nisha Chandra, M.D., associate professor of medicine and director of The Francis Scott Key Medical Center's coronary care unit. "When thrombolytic therapy is given, both genders fair better. When it is not, women experience proportionally more arrthymic deaths and heart ruptures than men," Chandra observes.
Results of the study are scheduled for presentation at the American College of Cardiology's 43rd Annual Scientific Session, Wednesday, March 16, 1994.
Chandra and her team looked at the effects of a particular clot-buster, t-PA. Like other thrombolytic therapies, t-PA is given to patients who seek treatment usually six hours after experiencing heart pain associated with a heart attack. The drug, given by an injection, breaks up potentially dangerous blood clots that form in arteries serving the heart says Chandra.
The researchers found that women who got thrombolytic therapy were much less likely to die compared with women who did not. Men who received thrombolytic therapy were less likely to die overall, but also were less likely to die of heart rupture and arrhythmias as compared to women (treated with thrombolytics). Not every heart attack victim is a candidate for thrombolytic therapy, however, says Chandra.
Though overall mortality and sudden death is reduced considerably in patients treated with t-PA, more deaths occur due to cardiogenic shock and heart rupture, in both men and women. Further analyses will help clarify whether these complications were, mostly related to older age, female gender or thrombolytic therapy.
The study was based on data from more than 214,000 patients in 891 hospitals enrolled in the National Registry of Myocardial Infarction, sponsored by Genentech Inc. (the maker of t-PA). Data collection, analysis and reporting is provided independently of the company.
"The Registry is not a controlled randomized trial, but provides a valuable observational data base, tracking the utilization of current therapies and documents clinical outcomes," says Chandra.
Other researchers include Alan J. Tiefenbrunn, M.D., of the Washington University School of Medicine, St. Louis; William J. French, M.D., of UCLA; Joel M. Gore, M.D., of the University of Massachusetts, and William J. Rogers, M.D., of the University of Alabama.