JHMI Office of Communications and Public Affairs

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

 


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