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10 December 2023

GCC women face increased risk of heart attack

The aim of the study was to evaluate the gender differences in baseline characteristics, therapy and outcomes in patients with acute coronary syndromes in six Middle Eastern countries. (REUTERS)

By Nadim Kawach

Women in the UAE and other Gulf countries are more vulnerable to heart diseases than men and females suffering from cardiac problems have higher death rates, according to a medical study obtained by Emirates Business.

The study, conducted by a group of doctors from the UAE, involved more than 8,000 male and female heart patients at 64 hospitals and medical centres in the UAE, Qatar, Oman, Bahrain, Kuwait and Yemen.

"The aim of ?the study was to evaluate the gender differences in baseline characteristics, therapy and outcomes in patients with acute coronary syndromes in six Middle Eastern countries," said Dr Wael Almahmeed, a cardiologist who participated in the research.

He told this newspaper ? that the study was conducted over a six-month period and it covered 8,169 patients, 74 per cent of whom are men.

"Women were nine years older than men and more likely to have diabetes, hypertension and dyslipidemia. Women were more likely to present with unstable angina and more often had atypical presentations of myocardial infarction," said Dr Wael.

"In all patients with acute coronary syndromes, women not only ranked higher on Global Registry of Acute Coronary Events risk score but also had increased in-hospital mortality, 1.75 times that of men. In conclusion, in addition to presentation with higher risk factors, female gender also independently predicted poorer outcomes in patients with myocardial infarction."

According to Dr Wael, the study, which was presented to a recent medical conference, demonstrated for the first time in a large registry in the Middle East that women with ACS had a higher mortality rate than men after adjustment for all confounders (age, heart rate, diabetes, hypertension, and GRACE risk score).

The study, Comparison of Men and Women With Acute Coronary Syndrome in Six Middle Eastern Countries, showed that women not only had a significantly higher risk for worse in-hospital outcomes, such as reinfarction, heart failure, cardiogenic shock and stroke, but "female gender also independently predicted a higher mortality rate compared to male gender".

"The worse outcomes in our study could be related to the observations that women more often presented late and with atypical symptoms and had longer door-to-needle times compared to men," said Dr Wael said.

"Also, missed diagnoses of myocardial infarction and more severe heart failure at presentation were more frequent in women. Furthermore, women were less likely to receive reperfusion and adjunctive therapies. Although treatment differences were in favour of men, the worse outcomes in women remained significant after adjustment for treatment variables."

Dr Wael noted that the study describes patients' characteristics in the eastern part of the Middle East, where the populations are similar in many aspects, including socioeconomics, ethnicity and culture.

"Our findings may not be generalised to other countries in the region with more diverse ethnic and religious backgrounds," he said.

"However, it also demonstrates that our results are consistent with those from other Middle Eastern, Western and Asian countries. The gender disparity is not a regional but a global issue that needs real effort and international awareness. Recognition of gender differences will lead to a number of quality improvement projects to improve the process of care."

According to the research, data were collected from a six-month prospective, multicentre study of the Gulf Registry of Acute Coronary Events (Gulf Race) that recruited 8,169 consecutive patients with ACS from six adjacent Arab nations.

Patients were enrolled from 64 hospitals with diagnoses of ACS, including unstable angina and ST elevation myocardial infarction.

"We enrolled 8,169 patients who were admitted with ACS, and data were successfully completed for 8,166 inpatients (6,183 men and 1983 women); three were missing. Women were nine years older than men and had diabetes, hypertension, obesity, and dyslipidemia more often than men," Dr Wael said.

"Smoking was more prevalent in men than in women. Women had more co-morbidities than men. However, there were no significant differences in histories of myocardial infarction or renal impairment between the genders."


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